Digital and immersive approaches to anatomy education: a pilot comparative study of CI, VR, and hybrid learning in implant planning

Abstract

Background: A solid understanding of anatomy is fundamental in dental education, and accurate interpretation of maxillofacial structures is essential across clinical contexts. Implantology is an example of a complex procedure that undergraduate students learn theoretically before supervised practice. Cone beam computed tomography (CBCT) provides the necessary radiological information, typically explored through conventional computer interfaces (CI). These non-immersive interfaces support diagnostic interpretation but may offer limited spatial engagement. Virtual reality (VR) provides an immersive 3D environment that may enhance conceptual understanding and long-term retention. Comparative evidence across CI, VR, and hybrid CI + VR modalities in undergraduate dental anatomy and implantology education remains limited. Methods: Twenty undergraduate dental students were randomly assigned to CI, VR, or CI + VR following a baseline lecture. Learning outcomes were assessed using a validated rubric at Pre-test (knowledge, understanding), Post-test (knowledge, understanding, application), and one-month Follow-Up. Quantitative outcomes were analysed using mean scores, mean differences, percentage change, and retention metrics. Complementary qualitative insights were obtained through short semi-structured interviews focusing on usability, visualization clarity, and perceived educational value. Results: All modalities improved performance in at least one domain. In Knowledge, mean scores increased from 2.00 to 2.71 in CI (p = 0.008), from 1.86 to 2.29 in VR (p = 0.078), and from 1.83 to 2.50 in CI + VR (p = 0.025). In Understanding, means increased from 4.57 to 6.00 in CI (p = 0.008), from 3.71 to 5.71 in VR (p = 0.004), and from 5.00 to 6.00 in CI + VR (p = 0.076). At Follow-Up, Knowledge means were 2.28 (CI), 2.00 (VR), and 2.33 (CI + VR), and Understanding means were 5.70 (CI), 5.70 (VR), and 5.60 (CI + VR). Application scores increased across all groups (CI: 6.00→6.42; VR: 4.71→5.55; CI + VR: 4.50→4.98). Interviews indicated that CI was valued for diagnostic precision, VR for immersive 3D visualization, and CI + VR for combining accuracy with experiential learning. Conclusions: Each instructional modality improved learning performance, but with distinct strengths. CI supported diagnostic precision, VR maximized conceptual understanding and retention, and CI + VR offered the most balanced gains with the strongest Knowledge stability. Qualitative findings aligned with these patterns, highlighting CI’s clarity, VR’s immersive engagement, and CI + VR’s combined benefits. Immersive and hybrid technologies therefore represent valuable complementary strategies for enhancing maxillofacial anatomy learning in dental education.