Multidimensional training in dental anatomy teaching of oral anatomy and physiology: practice and effectiveness

OBJECTIVE: To evaluate whether introducing 2-D "tooth-drawing" and 3-D "tooth-identification" exercises into conventional wax-carving sessions improves dental anatomy cognition among Chinese dental undergraduates. METHODS: Three consecutive cohorts were compared using ANCOVA with pre-course Grade Point Average (GPA) as covariate. The control group (2020 Cohort, n = 126) received traditional wax carving only. The 2021 cohort (n = 102) added supervised tooth-drawing practice and a summative tooth identification test. The 2022 cohort (n = 99) further integrated systematic drawing-to-identification scaffolding into instruction. Outcome measures included carving, identification, drawing and theoretical exam scores, plus a 5-point Likert student satisfaction survey. RESULTS: After adjusting for Pre-course GPA, significant differences were observed across cohorts in both theoretical and practical assessments. Tooth carving scores improved sequentially (2020: 83.23 ± 5.42; 2021: 84.77 ± 5.06; 2022: 85.11 ± 4.90), with the 2022 cohort significantly outperforming the 2020 cohort (p = 0.039). Dental anatomy theory scores showed a highly significant difference across cohorts (p = 0.002), where the 2020 cohort scored significantly lower than both the 2021 and 2022 cohorts (p < 0.001). Furthermore, extracted tooth identification accuracy markedly increased from 2021 to 2022 (62.23 ± 24.33 vs. 80.63 ± 24.23, p < 0.001), and tooth-drawing scores also showed a significant improvement (p = 0.003). Student satisfaction was high (mean 4.27/5), with 84.5% of respondents agreeing that multidimensional training enhanced their understanding of form-function relationships, and 87.6% reporting improved three-dimensional spatial imagination. CONCLUSION: This quasi-experimental historical-cohort study suggests that embedding structured "draw-identify-carve" training was associated with improved practical performance. The low-technology approach may be adaptable to resource-limited settings with access to paper, pencils, and extracted teeth, providing a scalable complement to high-technology solutions.