###### Abstract  
Teaching root canal anatomy has traditionally been reliant on static methods, but recent studies have explored the potential of advanced technologies like augmented reality (AR) to enhance learning and address the limitations of traditional training methods, such as the requirement for spatial imagination and the inability to simulate clinical scenarios fully. This study evaluated the potential of AR as a tool for teaching root canal anatomy in preclinical training in endodontics for predoctoral dental students. Six cone beam computed tomography (CBCT) images of teeth were selected. Board-certified endodontist and radiologist recorded the tooth type and classification of root canals. Then, STereoLithography (STL) files of the same images were imported into a virtual reality (VR) application and viewed through a VR head-mounted display. Forty-three third-year dental students were asked questions about root canal anatomy based on the CBCT images, and then, after the AR model. The time to respond to each question and feedback was recorded. Student responses were paired, and the difference between CBCT and AR scores was examined using a paired-sample \(t\)-test and set to \(p=0.05\). Students demonstrated a significant improvement in their ability to answer questions about root canal anatomy after utilizing the AR model (\(p<0.05\)). Female participants demonstrated significantly higher AR scores compared to male participants. However, gender did not significantly influence overall test scores. Furthermore, students required significantly less time to answer questions after using the AR model (M = 4.09, SD = 3.55) compared to the CBCT method (M = 15.21, SD = 8.01) (\(p<0.05\)). This indicates that AR may improve learning efficiency alongside comprehension. In a positive feedback survey, 93% of students reported that the AR simulation led to a better understanding of root canal anatomy than traditional CBCT interpretation. While this study highlights the potential of AR in learning root canal anatomy, further research is needed to explore its long-term impact and efficacy in clinical settings. virtual reality; root canal configuration; endodontics; CBCT; dental education +
Footnote †: journal: Applied Sciences  
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replace the actual space. AR utilizes head-mounted displays with stereo headphones and motion-tracking systems in medical anatomy education [2; 4]. XR technologies have emerged with promising potential to revolutionize dental education methods to train students before encountering actual patients. Subjective surveys favored the AR technique in gaining knowledge and skills in operative dentistry [4]. In-depth knowledge of identifying all canal anatomy is fundamental to learning skills needed to develop adequate quality root canal treatment and prevent mishaps. While traditional skill training remains effective in teaching root canal anatomy, it requires spatial imagination and inherits limitations to simulate clinical settings [5]. Certain endodontic competency skills mandate repeated projects and long practice [6]. Therefore, teaching root canal anatomy has recently been investigated to utilize AR technology [7]. A recent study indicated that most dental students supported using VR implementation to supplement traditional methods of acrylic teeth [8]. Endodontic residents trained in a virtual environment using the 3D computerized model generated from the original cone-beam computed tomography (CBCT) image data improved endodontic microsurgery performance [9]. While AR has shown promise in various dental applications, its utility in teaching root canal anatomy remains relatively unexplored. Challenges in developing accurate virtual models of root canal anatomy, primarily due to image artifacts and complex anatomical segmentation, have hindered the advancement of AR-based learning in this domain. To fully realize the potential of AR in endodontic education, a robust database of diverse and complex root canal anatomy cases is essential for creating practical AR simulations.