Comparative Analysis of Dental Anatomy Teaching Modalities' Effect on Preclinical Operative Psychomotor Performance.

Dental anatomy is fundamental in predoctoral dental education, providing essential knowledge that fosters good clinical practices. Although technology-enhanced teaching modalities have emerged in dental anatomy education, their comparative effectiveness in supporting the development of subsequent clinical skills remains inadequately explored. In this retrospective study, we compared three dental anatomy teaching modalities among first-year dental students (n = 326): traditional in-person instruction using human extracted teeth, alongside online and hybrid formats incorporating a 3D virtual tooth library. Learning outcomes were assessed through written examinations and preclinical operative skills evaluation, including Class I, II, and III cavity preparations; Class I and II amalgam restorations; and Class II, III, IV, and V composite restorations. ANOVA with Tukey's post hoc tests and Pearson's correlation coefficient were used for statistical analysis (p < 0.05). While dental anatomy midterm scores showed no significant differences across modalities, traditional instruction yielded significantly higher final examination scores (92.04 ± 5.12) compared to online (86.59 ± 6.15) and hybrid (85.69 ± 6.77) formats (p < 0.05). Students receiving traditional instruction demonstrated superior cavity preparation skills (76.5 ± 9.75), whereas the hybrid cohort excelled in restoration techniques (78.4 ± 6.43). Correlation analyses showed weak associations (r < 0.20) between dental anatomy final scores and subsequent performance measures. These findings demonstrate the complementary nature of traditional and technology-enhanced instruction in dental education, while revealing that theoretical knowledge and practical skills are more distinct than previously assumed, suggesting a need for domain-specific teaching strategies that optimize each area independently.