Background <p>Distant learning has undergone rapid development in dental education. However, integrating contemporary technologies with innovative instructional formats could further enhance student engagement and improve learning efficacy. This study evaluated the effectiveness of periodontal endoscopy assisted online simulation laboratory (sim-lab) training for “subgingival scaling and root planing (SRP)” instruction, with particular focus on student perceptions and learning outcomes.</p> Methods <p>The course was structured into five components: Pre-class preparation and quiz, theoretical lecture, teacher’s demonstration, guided students’ operation, and post-class support. A total of 178 fourth-year dental students participated in this study. Among them, 134 students experienced the periodontal endoscopy assisted learning approach. Within this group, 30 students attended the class in-person (Periodontal endoscopy assisted in-person group, PE in-person group), who had the opportunity to acquire practical experience in endoscopic operation. Meanwhile, 104 students participated in online lectures and demonstrations while receiving in-person guidance to develop their operative skills (Periodontal endoscopy assisted online group, PE online group). The remaining 44 students, who didn’t receive this endoscopy assisted learning method, served as the control group (Traditional teaching group, TT group). To evaluate students’ knowledge and skill acquisition, in-class quizzes and operative skill assessment were conducted. Additionally, anonymous questionnaires were distributed to collect students’ feedback on their teaching and learning experiences.</p> Results <p>All students across the three groups showed significant improvements in their test scores following the teaching intervention (<i>P</i> &lt; 0.05), with no statistically significant difference observed among the groups. Regarding operative skill assessment, students in PE in-person group demonstrated significantly higher scores than other groups (<i>P</i> = 0.017), primarily attributed to their superior performance in calculus removal (<i>P</i> = 002). A total of 147 valid questionnaires were collected. Students’ feedback indicated that students in both PE in-person group and PE online group rated the teaching method significantly higher in terms of its ability to stimulate students’ interest and boost their confidence in future learning and practice (<i>P</i> = 0.012, <i>P</i> = 0.013, respectively) compared to TT group. There was no significant difference in students’ ratings regarding other aspects, such as their satisfaction with the study module and its impact on their self-reported mastery of theories and techniques.</p> Conclusion <p>This study demonstrated the promising impact of periodontal endoscopy assisted teaching, both in-person and distantly. Hands-on endoscopic training significantly increased calculus removal efficacy. Importantly, the utilization of periodontal endoscopy in SRP instruction could significantly enhance students’ learning engagement and confidence in future practice. The findings supported the educational role of periodontal endoscopy as a supplementary tool that bridges the gap between theoretical knowledge and clinical application.</p>