Extended Reality in Endodontic Education: A Scoping Review of Educational Impact, Clinical Transferability, and Future Directions

BACKGROUND: Combined with haptic feedback systems, extended reality (XR) platforms enable immersive, multisensory learning environments that approximate the tactile, spatial, and proprioceptive demands of endodontic procedures. OBJECTIVE: To map and critically examine the current evidence regarding the application of XR technologies in endodontic education, with particular emphasis on educational outcomes, clinical transferability, and future directions for curricular integration. METHODOLOGY: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and conducted using the SPIDER framework to define eligibility criteria. Electronic searches were performed in PubMed (MEDLINE), Web of Science (All databases), and Scopus to identify studies evaluating XR-based simulation platforms in undergraduate and postgraduate endodontic training. Eligible studies assessed educational outcomes related to technical performance, knowledge acquisition, psychological impact, or learner perception. Findings were synthesized descriptively with a critical appraisal of methodological and pedagogical considerations. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS: XR-based simulation platforms have demonstrated consistent short-term improvements in technical performance, particularly in access cavity preparation, alongside enhanced learner engagement and structured feedback. Evidence also supports construct validity for certain haptic systems and positive effects on theoretical knowledge and confidence. However, substantial heterogeneity exists in study design, intervention protocols, and outcome measures. Most investigations are limited to short-term simulator-based metrics, with relatively few studies evaluating clinical transferability. Methodological variability and limited standardisation restrict the comparability of findings across platforms. CONCLUSIONS: XR technologies represent a meaningful adjunct in endodontic education, particularly for deliberate practice and objective skill assessment. Nevertheless, current evidence remains focused primarily on short-term outcomes. Future research should prioritise longitudinal designs, standardised evaluation frameworks, and clinically relevant endpoints to clarify the extent to which simulation-based gains translate into improved patient care.