Exploring the impact of immersive reality for enhancing clinical training in dental education: a systematic review

Abstract

Background

The acquisition of advanced dental skills typically necessitates extensive practical training. Currently, immersive reality (IR) represents an innovative approach that combines the physical and virtual worlds, providing an optimal learning experience for students. Despite the potential significance of immersive reality (IR) technology in dental education, the impact remains under-studied. This systematic review aimed to provide a thorough review of the benefits of IR technology in dental education.

Methods

Searches were conducted in PubMed, Embase, and Cochrane databases covering the years 2014 to 2025. The studies selected for inclusion focused on the effects and benefits of using immersive reality technology in dental training, comparing it to traditional dental training methods. Two independent researchers reviewed the selected studies, concentrating on aspects such as training duration, procedural time and errors, and the enhancement of knowledge and skills.

Results

13 studies were included. The main findings indicated that IR technology in dental education reduced procedural time and shortened training durations, decreasing errors while contributing to knowledge and skills development. Overall, these findings collectively provide strong evidence of the benefits of IR technology in dental education.

Conclusions

Integrating immersive reality into dental education offers a beneficial approach to support student engagement and skill development for future clinical practice.

Trial registration

PROSPERO CRD42024617799.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-09739-x.

Background

Dental education combines theory, laboratory work and clinical practice [1–3]. Preclinical and clinical training develop students’ motor skills and knowledge for patient management [4–9]. Digital tools and virtual simulation enhance learning by connecting information with clinical environments, advancing educational innovation [10–13].

Immersive reality (IR), a combination of virtual reality (VR) and augmented reality (AR) enhances dental education compared to traditional methods, particularly for complex procedures like oral surgery and tooth extraction [14–16]. IR enables students to independently repeat training sessions as needed [17–20]. These technologies improve fine motor skills and hand-eye coordination in pre-clinical settings, addressing financial and intellectual challenges in traditional training [15, 21–23]. The technology enables active student participation and enhances understanding of surgical procedures, creating a safer learning environment [15, 21–24].

Systematic reviews have recently highlighted that mixed reality (MR) technology plays a crucial role in enhancing the efficiency of orthognathic surgery planning. This technology provides valuable pre-surgical data and functions as a navigation aid during operations, leading to reduced surgical time while maintaining the quality of outcomes [25]. Moreover, VR technology improves knowledge acquisition and psychomotor/technical skills, as well as procedural skills and communication abilities [14, 26]. However, the effects of IR technology in dental practice and education remain unexplored. This systematic review evaluated IR’s impact on dental education, focusing on knowledge and skills as primary outcome, while procedural time and error as secondary outcome.

Objectives

This systematic review addressed the following research question: what is the evidence regarding the effectiveness of IR technology in improving clinical skills, reducing procedural errors, and enhancing knowledge acquisition among students, postgraduates, and trainees compared to conventional methods.

Methods

We registered the protocol (PROSPERO CRD42024617799) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines [27]. The completed PRISMA checklist is provided as additional file 1.

Eligibility criteria

Study characteristics

We included randomized controlled trials published in English from 2014 to 2025, excluding conference abstracts, protocols, and unpublished studies. Studies were excluded based on PICO framework (additional file 2). The Population included students, postgraduates, and trainees receiving dental education with IR technology; the intervention examined the use of IR technology for dental training and treatments; the comparator was conventional training and treatment methods; outcomes included procedural time, errors, knowledge and skill improvement as shown in Table 1.

Table 1.

Analysis of results based on outcomes for IR technology utilization in dental training

Author. Year. Country	Number of subjects	Specialization	Training case		Platform, devices	Outcomes
			Intervention	Comparator		Training duration (min)	Procedural time	Error	Knowledge/ skills improvement
Stevanie et al. [30] 2025. Indonesia	12 participants (engineer experts and students, OMFS experts and trainees)	Oral surgery	Le Fort I (LFI) Orthognathic Surgery Simulation	NS	• Unity game engine. • Oculus Meta Quest 3(Meta Platforms, Inc., Menlo Park, CA, USA).	45–60 min	NS	NS	The training systems reliable and suitable for learning process, completed with good picture and almost similar to real surgery without significant cybersickness
Fu et al. [5] 2024. China	108 fourth-year students	Periodontology	Periodontal scaling on virtual simulation technology (VS)	• TT group: perform scaling on traditional pathological typodont (n = 36) • QE group: perform scaling on quail egg (n = 36)	• UniDental VS system (Beijing UniDraw Virtual Reality Technology Research Institute Co., Ltd., 2014).	90 min	NS	NS	Students had better understand about scaling procedure in challenging location.
Peters et al. [29] 2023. Germany	150 participants	Oral surgery	Single button suture technique using HMD-based course (stereoscopic, immersive) (n = 49)	• Single button suture technique using e-learning course (monoscopic) (n = 51) • Single button suture technique using both self-directed and a tutor-led course with feedback (n = 50)	• Oculus quest 2 VR-HMD (Meta platforms Inc., United States).	• 40 min recorded lecture and 180° instruction video with HMD • 60 min self-directed training	NS	NS	Stereoscopic and immersive learning through HMD help students concentrate to the learning substances.
Philip et al. [35] 2023. Switzerland	14 students	Pediatric dentistry	Pulpotomy on primary teeth using SIMtoCARE DENTE ® (n = 7)	Pulpotomy on primary teeth using conventional mannequin simulator (n = 7)	• SIMtoCARE Dente® (SIMtoCARE B.V., Vreeland, The Netherlands). • Courseware (Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands).	60 min	23.7 ± 1 min (lower than conventional method 25.9 ± 8.9 min).	NS	Higher scores achieved compared with conventional method.
Daud et al. [4] 2023. Qatar	23 dental students	Operative dentistry	Performed Class I cavity preparation in CSE, followed by same exercise using VRHS (#46)	Performed Class I cavity preparation with VRHS, followed by same exercise using phantom head/acrylic typodont teeth in CSE (#46)	• SIMtoCARE Dente® (SIMtoCARE B.V., Vreeland, The Netherlands).	40 min	NS	NS	Students strongly agreed that VRHS can be used as supplement on pre-clinical training.
Lu et al. [36] 2022. China	199 students of fourth-year stomatology course	Pediatric dentistry	Watch video of pulpotomy, perform pulpotomy on the virtual experimental platform and practice the virtual simulation experimental course (n = 101)	Watch video of pulpotomy but did not perform virtual simulation (n = 98)	• Beijing Rainier Network Technology (Beijing, China; www.rainier.et.cn). • iLab x (www.ilab-x. com).	NS	NS	NS	Grades Band C of experimental group had higher score than control group. Students thought experimental virtual simulation very helpful master the difficult aspects of pulpotomy.
Mansoory et al. [38] 2022. Iran	50 dental students	Prosthodontia	Practical skill test on the neutral zone design and teeth arrangement using virtual reality-based instruction (n = 25)	Practical skill test on the neutral zone design and teeth arrangement using lecture method (n = 25)	• Unity game engine • Gear VR (Samsung Company Inc. Oculus Company).	NS	NS	NS	Students in experimental group had higher score in practical skills of neutral zone design. No significant differences on teeth arrangement practical skill test.
San Diego et al. [31] 2022. United Kingdom	264 first-year students	Operative dentistry	Removal of artificial carious lesions on haptic-based simulators (n = 91)	Removal of artificial caries on ADEC dental chair simulator (phantom-head) (n = 173)	• Haptic-based simulators	NS	NS	NS	• Students holding instruments appropriately. • No difference in the quality of cavity cut.
Sytek et al. [37] 2021. USA	20 graduated students of orthodontia department	Orthodontia	Orthodontic treatment planning.	NS	• Oculus Rift HMD (Oculus VR Inc., Menlo Park, CA). • Jugular software (University of Michigan’s VR platform).	NS	5.823 min	NS	• VR brings positive attitudes toward higher fidelity tools with regard to visualization, manipulation, and student’s enjoyment.
Vincent et al. [32] 2020. France	88 first-year dental students	Operative dentistry	Black’s Class II cavity on a first right mandibular molar (#46) using haptic simulator VirtEasy (n = 45)	Black’s Class II cavity on a first right mandibular molar (#46) using conventional plastic analogue teeth (Kavo) (n = 43)	• VirtEasy haptic simulator (VirtEaSy Dental©, France) • Geomagic touch x haptic device (Geomagic Inc., Morrisville, NC, USA).	10 min	10 min	NS	• Simulator usage effectively improved student’s dexterity when experiencing a physical model for the first time.
Dwisaptarini et al. [33] 2018. Indonesia	32 sixth-year dental students	Operative dentistry	Minimal invasive caries-removal training on virtual reality simulator (n = 16)	Minimal invasive caries-removal training on conventional extracted teeth (n = 16)	Omni haptic device (SensAble, Inc, Woburn, MA, USA).		10.82 ± 4.17 min (faster than control group 10.87 ± 4.47)		VR simulator training had equivalent effects in improving visuo-tactile performance of students.
Pulijala et al. [19] 2018. United Kingdom	95 novice residents	Oral surgery	Le Fort I osteotomy using VR surgery application on an oculus rift with leap motion device (n = 51).	Le Fort I osteotomy used similar content in a standard PowerPoint presentation on a laptop (n = 44)	• Oculus Rift HMD (Oculus VR Inc., Menlo Park, CA) • Leap Motion controllers	45 min	NS	NS	Significant higher self confidence level of first-year novices.
Al-Saud et al. [34] 2016. United Kingdom	63 undergraduate dental students	Operative dentistry	Tooth drilling with five geometric shapes, with depths of 0.4 mm and 0.8 mm, received device feedback only (n = 21)	• Tooth drilling with five geometric shapes, with depths of 0.4 mm and 0.8 mm, received verbal feedback from instructor (n = 21) • Tooth drilling with five geometric shapes, with depths of 0.4 mm and 0.8 mm, received combination of instructor and device feedback (n = 21)	• Simodont VR haptic dental simulator (MOOG, Nieuw-Vennep, Netherlands). • Courseware (Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands).	Not significantly different in all groups.	DFB higher percentage than other groups.	IDFB group lower (13.68) than DFB group (21.4).	Integration of VR into a dental curriculum needs consideration to maximize VR’s potential utility in motor skill learning and to complement existing simulation techniques.

Abbreviations NS Not specified, mm millimeters, IDFB instructor device feedback, DFB device feedback, QE quail egg, TT typodont teeth, VRHS virtual reality haptic simulation, CSE conventional simulation environment

Search strategy and selection process

Database searching

PubMed, Cochrane, and Embase searches focused on research articles from 2014 to 2025, ensuring current information for analysis. The study identified randomized clinical trials (RCTs) and pilot studies using keywords following medical subject headings (MeSH) terms, including ‘computer simulation’, ‘dental’, ‘education’, ‘competency-based education’, ‘simulation training’, and ‘virtual reality’. Search strategies were database-specific, with details in additional file 3. The initial search in June 2025 was updated in August 2025. Further evaluations of immersive reality-based dental training and their citations found 25 studies that might be relevant for further examination.

Screening

After removing duplicates, we screened 135 records. Two authors (M.R. and C.S.) independently reviewed titles and abstracts to identify relevant studies based on PICO framework. Irrelevant studies were excluded with documented rationale. For disagreements, a third author (O. A.) was consulted. Full texts of potentially relevant articles were evaluated, with non-compliant studies eliminated and reasons recorded.

The eligibility criteria included: (i) research with populations of students, postgraduates, and trainees utilizing IR technology for dental training, (ii) pilot study and RCTs study designs, and (iii) human, cadaver, artificial tooth or study models as study samples receiving IR technology interventions. Studies were excluded if they were: (i) review articles; (ii) did not involve IR technology in dental education and treatments; (iii) failed to describe advantages or outcomes of IR technology in dental education.

Data collected included authors, publication year, country, number of subjects, specialization, training case, platforms and devices, and outcomes including training duration, procedural time, errors and knowledge/skill improvement. Results are summarized in Table 1.

Study risk of bias assessment

All the studies included in the current systematic review were RCTs and pilot studies. The risk of bias associated with the studies included was evaluated using the Joanna Briggs Institute (JBI) assessment tool [28] as tabulated in Table 2.

Table 2.

The risk of bias of included studies based on the Joanna Briggs Institute (JBI) assessment for Randomized Controlled Study [28]

JBI Assessment Tools	Questions													Overall bias
	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	Q12	Q13	(Yes/total question)	Interpretation
Stevanie et al., [30] 2025	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Fu et al., [5] 2024	✔	✔	✔	✔	✔	?	✔	✔	✔	✔	✔	✔	✔	12/13	Minor risk
Peters et al., [29]2023	✔	✔	?	✔	✔	×	✔	✔	✔	✔	✔	✔	✔	11/13	Minor risk
Philip et al., [35]2023	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Daud et al., [4] 2023	✔	✔	✔	×	×	✔	✔	✔	✔	✔	✔	✔	✔	11/13	Minor risk
Lu et al., [36] 2022	✔	✔	✔	✔	✔	✔	✔	✔	?	✔	✔	✔	✔	12/13	Minor risk
Mansoory et al., [38] 2022	✔	✔	✔	✔	✔	✔	✔	✔	?	✔	✔	✔	✔	12/13	Minor risk
San Diego et al., [31] 2022	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Sytek et al., [37] 2021	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Vincent et al., [32] 2020	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Dwisaptarini et al., [33] 2018	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Pulijala et al., [19] 2018	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk
Al-Saud et al., [34] 2016	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	✔	13/13	Low risk

Abbreviations ✔(Yes), × (No), ? (Unclear), ⊘ (Not applicable)

Synthesis of the summary measures

Data from selected articles were extracted to evaluate the outcomes of IR technology training in dental procedures. All findings related to training duration, procedural time, errors, and knowledge and skill improvements were included regardless of outcome direction. Comparisons between publications were not possible due to heterogeneity in dental training and IR technology fields, preventing meta-analyses.

The outcomes extracted were categorized into i) ‘Procedural time’ for completing the procedure; ii) ‘Error’ describing participant errors and deviations from real objects; and iii) ‘Knowledge/skill improvement’ showing participant progress after virtual training.

Results

Characteristics of included studies

After removing duplicates, 135 articles were identified through the search. Review of titles and abstracts excluded several articles, leaving 30 potentially relevant ones.

These 30 full-text articles were screened using predetermined inclusion criteria. Thirteen studies met the criteria and were included, while seventeen studies were excluded after evaluation. A flowchart showing the study selection process and exclusion reasons is shown in Fig. 1.

Fig. 1.

Flowchart of the article selection process (PRISMA 2020 flowchart)

The systematic review encompassed thirteen studies, all of which were RCTs and pilot studies conducted between 2014 and 2025. The usage of IR technology training system in oral surgery was evaluated in three studies [19, 29, 30], while four studies focused on operative dentistry [4, 31–33], two studies on pediatric dentistry [34, 35], one study on orthodontics [36], two study on prosthodontia [37, 38], and one study on periodontia [5] as shown in Fig. 2.

Fig. 2.

Studies distribution based on dental specialty category

Among the included studies, the most common IR headset utilized was Oculus Rift [19, 37], followed by Oculus Meta Quest [29, 30]. The most frequently utilized supporting IR platforms included are SIMtoCARE dente [4, 35], Courseware [34, 35], Unity Game Engine [30, 37], Leap motion [19], UniDental VS System [5], iLab X [36], Simodont [34], Jugular software [37], Beijing Rainier [32, 36]and VirtEasy [32]. Additionally, utilization of haptic devices was reported in two studies, including Geomagic X [32], and Omni haptic [33]. A summary of outcomes analysis is presented in Table 1.

Risk of bias

Most of the included studies exhibit a very low risk of bias, indicating a high level of methodological quality across the literature. Over half of studies category (7 out of 13) meets every JBI criterion [19, 30–35], while five studies categorized as minor risk [4, 5, 29, 36, 38] due to lacked clarity in one or two domains. These findings suggest that the fundamental requirements for rigorous research were met by all authors. The detailed risk of bias assessment of all the studies can be found in Table 2.

Summary of results

In the reviewed studies, various assessments were conducted to evaluate the benefits of the interventions of IR technology in dental training procedures. Out of the thirteen studies that met the inclusion criteria, all studies examined knowledge/skill improvement, while nine studies reported the training duration [4, 5, 19, 29, 30, 32, 34, 35, 37], procedural time was evaluated in five studies [32–35, 37], and one study evaluated system errors [34].

In a comparative evaluation of training effectiveness, eleven studies [4, 5, 19, 29, 31–36, 38] revealed distinctions between traditional training methods and those based on IR. Additionally, two other studies which lacked control groups, also provided evidence supporting the impact of IR-based on participants [30, 37]. These studies demonstrated improvements in technical skills and performance among students, postgraduates and trainees.

Training duration

Training duration affects student engagement in simulations. Peters et al. compared e-learning, HMD-based and tutor-led training methods for performing simple sutures [29]. The training included 40 min lectures with HMD instruction video and 60 min self-directed training [29]. Course suitability was highest for tutor-led (x̄=4.8), followed by HMD-based (x̄=3.6) and e-learning (x̄=2.5). Fu et al. conducted 90 min dental scaling training comparing virtual simulator (VS) with typodont (TT) and quail egg (QE) [5]. VS group scored higher (87.89 ± 6.81) than QE (83.53 ± 8.14) and TT groups (85.05 ± 6.81) [5].

Stevanie et al. studied an IR training system for Le Fort I (LFI) Orthognathic surgery (OGS). The 45–60-minute training involved 12 participants, including engineers, students, OMFS specialists, and trainees [30]. The study showed IR training systems provide realistic surgical simulation without significant cybersickness, improving trainees’ understanding of LFI OGS [30]. Philip et al. reported on 60-minute training using SIMtoCARE dente^® haptic virtual reality simulator for pulpotomy, comparing it with conventional training [35]. The perception questionnaire showed comparable results between methods, with participants endorsing HVRS for pre-clinical training [35]. Similarly, Daud et al. used SIMtoCare dente^® for Class I tooth preparation training [4]. The study found strong agreement among 23 students that virtual reality with haptic simulation (VRHS) enhanced pre-clinical training and manual dexterity [4].

Sytek et al. report that orthodontic residents performed 2D, 3D and VR treatment planning tasks [37]. Training times were 2.13, 3.95 and 6.59 min respectively. Board Case Oral Examination scores showed 3D simulation achieved highest (56.69), followed by VR (56.38) and 2D (55.21) [37]. Participants praised VR training for its accuracy and immersive environment [37]. Vincent et al. found virtual drilling time decreased from 216 ± 107 to 150 ± 60 s, while conventional method time reduced from 547 ± 73 to 424 ± 105 s [37]. Virtual training achieved similar outcomes in less time, demonstrating IR simulator’s effectiveness in training.

Procedural time and errors

Philip et al. found students using HVRS with SIMtoCARE dente^® for pulpotomy had lower procedural time (23.7 ± 1 min) versus conventional simulators (25.9 ± 8.9 min) [35]. Similarly, Sytek et al. compared VR, 3D and 2D orthodontics planning among orthodontic residents [37]. Students using VR and 3D planning had more questions about software features and showed increased movements during practice, though treatment plan scores matched 2D analysis [37]. VR and 3D tasks required more time to complete. Students reported positive feedback regarding visualization quality and simulation experience. Vincent et al. showed the haptic simulator VirtEasy’s effectiveness in restorative dentistry training, finding no significant differences compared to conventional practice on plastic teeth (Kavo) [32].

Knowledge and skill improvement

Lu et al. found that students receiving IR training for pulpotomy achieved higher scores than those with conventional training [36]. Studies reported the advantage of IR simulator in oral surgery [19, 29]. Peters et al. found IR simulator suture training provided immersive learning and enhanced student concentration [29]. Similarly, Pulijala et al. showed IR-based Le Fort I Osteotomy training improved novice surgeons’ self-confidence and performance [19].

IR technology is utilized in operative dentistry procedures. Daud et al. used IR for Black’s Class I cavity preparation training with 23 dental students, who strongly agreed that virtual reality could complement their learning [4]. San Diego et al. found haptic-based simulator training enabled first-year students to handle dental instruments comparable to conventional training [31]. Vincent et al. showed IR simulation for Black’s Class II cavity preparation improved student dexterity in real procedures [32].

Dwisaptarini et al. studied minimal invasive caries removal training among sixth-year students, concluding VR simulator training equivalently improved visuo-tactile performance [33]. Al-Saud et al. found IR-based training enhanced student’s motor skills in cavity preparation [34]. In periodontology, IR-based dental scaling training improved students’ skills for treating real patients [5].

Virtual simulator helped students to improve their knowledge and achieve higher score. Lu et al. that discovered higher score achieved by dental students who had IR training for pulpotomy in pediatric dentistry compared with control group who had conventional training [36].

Discussion

Students can learn through textbooks, tutorials, videos, live demos or hands-on practice with patients [1, 3]. Traditional methods often fail to provide sufficient understanding, as mastering procedures independently requires years of experience [39].

Prolonged procedural time (the time taken to complete a task/case) in surgical practices correlates with operator skills and knowledge developed through training which doubles complication risks [10, 21, 40]. Inexperienced operators often require extended decision-making periods during surgery [41]. Longer operations increase risks of complications like wound dehiscence, infection, and paresthesia [41–43].

IR simulators offer a safe, controlled environment and repeatable training to reinforce skills with interactive real-time training for easier procedural learning [7, 17, 22, 23, 44, 45]. Students can practice dental procedures aligned with curriculum knowledge from lectures [7, 14, 45].

Moussa et al. found VR technology in teaching simulation improves dental education quality and highlighted that 3D simulation enhances student understanding and deepen teacher’s guidance [46]. IR-based learning matches conventional methods’ effectiveness [14], improving theoretical knowledge and practical skills while boosting student confidence and creating engaging environments.

IR technologies enhance dental education outcomes [47, 48]. The IR system enables progress monitoring, helping students gain improved knowledge and clinical skills, resulting in better healthcare outcomes with fewer complications [18, 25, 49–52]. Additionally, Haptic devices improved students’ motor skills during cavity preparation, outperforming traditional simulations [46, 53]. IR environments enhance anatomical understanding [17, 18], particularly in endodontic training where simulations improved root canal comprehension [14, 46]. Repeating procedures without time constraints develops expertise and reduces errors. IR’s immersive nature increased student engagement [14, 46].

Despite their advantages, IR technologies have limitations. High costs for hardware and software pose barriers [46]. Technical maintenance expertise may be unavailable at institutions. Variations in IR fidelity require standardized design [54, 55]. Assessment relies heavily on subjective self-reported surveys [56]. Quantitative measures like procedural time and error rates would better evaluate effectiveness [14, 46]. The findings support implementing IR as a complement to traditional dental education methods.

Limitations

Due to high heterogeneity of included publications, comparisons and meta-analysis were impossible. We focused on experimental studies as evidence for immersive reality training effectiveness in dental education.

Conclusion

IR technology offers a novel approach to dental education by combining immersive experiences with opportunities for skill development and student engagement. As such, IR technology has the potential to effectively supplement dental training and contribute to student’s clinical skills preparation.

Supplementary Information

12909_2026_9739_MOESM1_ESM.docx ^{(269.4KB, docx)}

Additional file 1. PRISMA 2020 Checklist.

Additional file 2. PICO framework. ^{(16.1KB, docx)}

12909_2026_9739_MOESM3_ESM.docx ^{(14.7KB, docx)}

Additional file 3. Search strategy of each database.

Abbreviations

PICO

Population, Intervention, Comparison, Outcome

IR

Immersive reality

AR

Augmented reality

VR

Virtual reality

x̄

Mean of dataset

Authors’ contributions

Muhammad Ruslin: conceptualization, data curation, writing-original draft, writing-review & editing; Endang Sjamsudin: formal analysis, methodology, software, visualization; Olivia Avriyanti Hanafiah: formal analysis, methodology, project administration; Carolina Stevanie: data curation, writing- original draft, writing- review & editing; Sri Hastuti Kurniawan: conceptualization, investigation; Muh Anshar: visualization, software, project administration; Paolo Boffano: supervision, validation; Tymour Forouzanfar: conceptualization, investigation; Cortino Sukotjo: conceptualization, investigation. All authors read and approved the final manuscript.

Funding

No funding applicable on this work.

Data availability

All data generated or analyzed during this study will be made available upon reasonable request.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Conflict of interest

The authors declare that they have no competing interests.