Practitioners' Perceptions of Augmented and Virtual Reality in Endodontic Treatment Planning: A Pilot Study

Area of Science:

• Dental imaging and endodontics
• Computer-aided diagnosis
• Immersive technologies in medicine

Background:

• Conventional cone-beam computed tomography (CBCT) analysis involves mentally reconstructing 3D anatomy from 2D slices, increasing cognitive load.
• Advanced visualization modalities like augmented reality (AR) and virtual reality (VR) offer potential improvements in endodontic treatment planning.

Purpose of the Study:

• To develop a streamlined software workflow for converting CBCT data into AR and VR formats.
• To evaluate dental practitioners' perceptions of AR and VR compared to conventional CBCT analysis for endodontic treatment planning.

Main Methods:

• A custom Blender add-on, VirtualEndo, was created to process AI-segmented CBCT scans into AR/VR formats.
• Thirty dentists assessed two challenging endodontic cases using conventional CBCT, AI segmentation, AR (iPad), and VR (Meta Quest 3).
• Perceptions of diagnostic confidence, usability, information extraction, and clinical relevance were measured using Likert scales and analyzed with Friedman and Wilcoxon tests.

Main Results:

• All advanced visualization methods (Segmentation, AR, VR) were rated significantly superior to conventional CBCT for information extraction and usability.
• No significant differences were found between AR, VR, and segmentation methods.
• AI-driven segmentation was most frequently deemed clinically relevant (40%), followed by VR (20%). Canal detection showed minimal differences across methods.

Conclusions:

• 3D visualization technologies (AR, VR, segmentation) are perceived as superior to conventional 2D CBCT analysis for endodontic treatment planning.
• These technologies reduce cognitive burden by presenting integrated anatomical models.
• Screen-based segmentation offers pragmatic workflow integration, while immersive VR/AR show promise pending adoption barriers.