From Images to Specimens: The Impact of Tactile, Three-Dimensional Learning in Dental Anatomy

Background: A solid understanding of dental and craniofacial anatomy is essential for reliable clinical practice, yet long-term retention of anatomical knowledge is known to decline as students progress through their training. Although digital- and image-based resources are widely used in anatomy education, it remains unclear whether two-dimensional (2D) representations support durable recognition of complex anatomical structures. This study investigated whether tactile engagement with real three-dimensional (3D) anatomical specimens enhances long-term identification accuracy compared with standardized 2D images. Materials and Methods: Eighty-nine fifth-year dental students at the University of Oslo were assessed approximately 2.5 years after completing their formal anatomy course. All students completed two sequential identification tests on the same day: a 2D image-based test followed immediately by an equivalent test using real extracted human teeth and real skull bones. The assessments comprised 28 osteology structures and 14 teeth. Performance between conditions was compared using mixed-effects logistic regression with test modality as a fixed effect and participant and anatomical item as crossed random effects. Results: Overall identification accuracy increased from 52% in the 2D condition to 74% in the 3D tactile condition (p < 0.0001). Mean accuracy for osteology improved from 0.519 (SD = 0.074) to 0.708 (SD = 0.072) (p < 0.0001), while tooth morphology scores increased from 0.535 (SD = 0.097) to 0.795 (SD = 0.110) (p < 0.0001). All individual teeth and nearly all osteological structures showed significantly higher identification accuracy in the 3D condition. The largest gains were observed for structures with low 2D recognition. Conclusions: Tactile interaction with real 3D anatomical specimens substantially enhances long-term recognition of dental and craniofacial anatomy. These findings support the continued integration of hands-on, three-dimensional learning alongside digital resources in dental anatomy education to promote durable anatomical understanding and clinical preparedness.