Precision Beyond Perception: Mixed Reality Transforming Modern Endodontics
M. Shrija
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, 603 203, Tamil Nadu, India.
T. Vinay Kumar Reddy *
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, 603 203, Tamil Nadu, India.
K. Vijay Venkatesh
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, 603 203, Tamil Nadu, India.
B. Shyam
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, 603 203, Tamil Nadu, India.
Seetha Kunhikannan
Department of Pharmacovigilance Specialists, Chennai One IT Park, Thoraipakkam, Chennai, 600 097, Tamil Nadu, India.
*Author to whom correspondence should be addressed.
Abstract
Successful endodontic treatment depends on accurate interpretation of complex root canal anatomy, which may be obscured by calcification, restorations, curvature, or limited direct visibility. This narrative review examines the development of computer-assisted and immersive technologies in endodontics, with particular emphasis on mixed reality as an emerging adjunct for access cavity preparation, canal localisation, treatment planning, and education. It traces the progression from static guided endodontic templates to dynamic navigation systems and head-mounted augmented- or mixed-reality displays that use cone-beam computed tomography or computed tomography data to support three-dimensional spatial understanding of the tooth. The evidence reviewed indicates that guided and immersive approaches may improve the accuracy of access preparation and canal localisation compared with conventional freehand methods, particularly in technically difficult cases such as calcified canals. Mixed reality may also support treatment planning by keeping three-dimensional anatomical information within the clinician’s visual field. However, the available evidence remains largely based on in vitro studies, ex vivo models, proof-of-concept reports, narrative reviews, and limited case-level evidence. Important barriers include registration accuracy, depth perception, headset comfort, restricted field of view, cost, the learning curve, and the absence of standardised clinical outcome measures. Mixed reality should therefore be regarded as a promising research direction rather than an established routine chairside procedure.
Keywords: Mixed reality, augmented reality, guided endodontics, dynamic navigation, root canal therapy, cone-beam computed tomography (CBCT), head-mounted display, endodontic education