Procedural accuracy and efficiency of 3D versus conventional dental microscopes in novice users

Abstract This study compared procedural performance and user experience under three visualization conditions: unaided vision, dental operating microscope (DOM), and three-dimensional dental operating microscope (3D-DOM). In this experimental repeated-measures study, thirty dental students performed a targeting task in randomized order using a DOM (Flexion Advanced, CJ-Optik, Germany) and a 3D-DOM (Promise Vision 3D™, Seiler, USA) at 8× magnification, with a two-week washout period. Accuracy (0–4 scale), task time, and participant-reported outcomes (CVI-S = 0.90) were assessed. Data were analyzed using repeated-measures ANOVA, Friedman test, Bonferroni-adjusted post hoc comparisons, and Spearman correlation ( p < 0.05). Magnification significantly improved procedural accuracy compared to unaided vision ( p < 0.001). The DOM achieved the highest accuracy (3.40 ± 0.30), required the longest task time (5.14 ± 1.70 min) and provided the greatest visual clarity, although 13.3% of participants reported image splitting with greater difficulty in spatial orientation. In contrast, the 3D-DOM demonstrated a more balanced performance between accuracy and efficiency (3.36 ± 0.20; 3.20 ± 0.81 min), with improved spatial orientation, reduced visual discomfort, and the most favorable ergonomic outcomes ( p < 0.05). These findings indicate that while DOM optimizes visual precision, 3D-DOM achieves a more favorable balance between efficiency, usability, and operator ergonomics.