Extended reality technology for alleviating adult dental anxiety: A systematic review and meta-analysis of randomized controlled trials.

Objectives: To assess the effectiveness of extended reality (XR) technology in reducing dental anxiety in adults, through a systematic review and meta-analysis.

Methods: Comprehensive electronic and manual searches were conducted to identify randomized controlled trials published up to November 23, 2024, with no restrictions on publication year or language. Key outcomes included changes in anxiety and pain levels and cardiovascular indicators, such as blood pressure, heart rate, and oxygen saturation (SpO2). A random-effects model was used to evaluate the combined effects, with subgroup analyses exploring potential influencing factors. The updated Cochrane Risk of Bias 2 tool was used to assess the risk of bias. Meta-analysis was performed using RevMan 5.4.

Results: Of 1,207 screened records, 52 were retrieved for full-text evaluation, resulting in 10 studies meeting the inclusion criteria. The meta-analysis revealed that XR technology significantly reduced anxiety (mean difference [MD]:3.22, 95 % confidence interval [CI]:3.83 to -2.61; I² = 85 %), pain (MD:1.30, 95 % CI:2.07 to -0.53; I² = 84 %), and blood pressure scores (MD:3.34, 95 % CI:4.76 to -1.92; I² = 2 %). For cardiovascular indicators (heart rate, pulse, and SpO₂), the overall effect size was -3.83 (95 % CI:5.54 to -2.13; I² = 83 %).

Conclusions: Our findings suggest that XR technology effectively alleviates dental anxiety in adults. However, larger, rigorously designed trials to better understand its impact.

Clinical Significance: XR technology reduces patients' blood pressure, heart rate, pain, and anxiety during dental treatments. Rigorous, large-scale trials are needed to confirm its clinical effectiveness.