High resolution images and 3D models of the root canal anatomy enhance reflective reasoning in dental students. A qualitative and quantitative assessment.

To evaluate the educational value of high-resolution micro-CT images and 3D models of maxillary premolars in enhancing dental students' understanding of root canal complexity and reflective reasoning. Eighteen extracted adult maxillary premolars were scanned using a micro-CT system (SkyScan 1273, Bruker, Belgium) to create high-resolution images and 3D models compiled into a digital atlas. A mixed-methods design was implemented. In the quantitative phase, 94 dental students reviewed the materials and completed a seven-item questionnaire on a 10-point Likert scale assessing perceived usefulness, motivation, and learning contribution. In the qualitative phase, 15 students participated in focus groups guided by the See/Think/Wonder routine. They analyzed periapical radiographs followed by the micro-CT images and 3D models and produced hand-drawn representations of premolars before and after the intervention. Quantitative data were analyzed using descriptive statistics and nonparametric paired tests, while qualitative data were coded and examined with Atlas.ti. Students reported high agreement across items (median scores 9-10), indicating that the digital materials better illustrate root channels, were intuitive, helped them understand better, should complement their studies, motivated them to learn, and contributed to their learning and treatments. Post-intervention drawings demonstrated significantly greater anatomical detail, including accessory canals and apical deltas. Qualitative findings revealed more complex, clinically oriented reasoning, though some students expressed uncertainty or anxiety upon recognizing anatomical variability. High-resolution micro-CT images and 3D models enhance comprehension of root canal complexity and foster reflective reasoning, although increased awareness of anatomical variability may generate anxiety in some learners.