## 1 Introduction  
Undergraduate dental students are expected to develop competence in a range of operative procedures to enable them to deliver safe and effective clinical dental care [1]. Dentistry involves performing invasive procedures which may cause irreversible harm to the patients. A fundamental strategy to ensure safe clinical care by dental students is to provide preclinical training in simulated dental learning environment. Simulated settings provide a safe learning environment and are particularly important for training and assessments of students irreversible dental procedures before they undertake these procedures on real patients in clinical settings [2]. Development of competence in practical skills in operative dental procedures requires acquisition of fine motor skills involving hand-foot and eye coordination. Historically, preclinical training has been largely based on learning operative dental skills on extracted natural teeth as well as plastic teeth (typodonts), which are mounted as models on mannequins [3]. This approach is well-established in most dental schools globally and has been used for several decades. However, training on mannequins entails a running expenditure on materials with limited opportunities for repeated practice by the students. Moreover, it requires availability of appropriately qualified supervisors and potential issues of inter-rater reliability during assessments of dental students [4, 5]. Dental virtual reality simulators with haptic feedback are becoming increasingly popular in dental schools and can potentially address some of the limitations of endodontic teaching on mannequins. The available systems can evaluate the learning process and provide immediate feedback with minimal supervisor dependence [4]. Apart from haptic feedback during the exercise, students have the opportunity to practice repeatedly without any additional cost implications [6; 7]. Moreover, students receive immediate, three-dimensional, audio and written feedback on their work on artificial teeth (such as a cavity, crown, and endodontic access preparations). In addition, they may be able to review their work following completion as a playback video file [8]. Several studies have been conducted to test the validity of Virtual Reality (VR) technology [6; 9; 10]. Previous work by [PERSON] has shown that stakeholders view VR simulators positively and students trained on VRDS learned faster, demonstrated the same level of performance, accomplished more practice procedures per hour, and requested more evaluations than in the traditional preclinical laboratories [9]. [PERSON] et al., reported that the quality of the student preparations when comparing students using only traditional instruction and those who used the VRDS are comparable [10]. Studies have also reported that VR technology improves student performance, and allows them to obtain higher examination and course scores [8; 9; 10]. There is a growing trend of using VR in a preclinical dental curricula as VRDS training has a positive impact on students' ergonomic development and technical performance [8; 9; 11; 12; 13]. Evidence from the literature suggests that teaching endodontics to undergraduate dental students presents multiple challenges for dental educators [14] Most students view this discipline as complex and difficult to master, which in turn reflects on their skills and confidence in performing root canal treatment, especially on multi-rooted teeth [15]. Competency in endodontics is widely recognized as one of the more challenging skills for undergraduate dental students, as reported in multiple studies [16; 17]. A variety of strategies have been employed in preclinical endodontic teaching, including a comparison of training on artificial or natural teeth; use of apex locator during preclinical training in endodontics; and evaluation of the technical quality of root canal treatment performed by the undergraduate students [18; 19].