Puteri Anastasha1, Teo Jia Yi1, Firdaus Razali1, Nasir Nilofer Nisha2
1Faculty of Dentistry, Mahsa University, Selangor, Malaysia.
2Senior Lecturer, Department of Conservative Dentistry,
Faculty of Dentistry, Mahsa University, Selangor, Malaysia.
*Corresponding Author E-mail: nilofer@mahsa.edu.my.com
ABSTRACT:
Dental implants are a widely used treatment option with favourable long-term results. However, implants may fail due to mechanical or biological complications, necessitating sufficient knowledge and training in implant dentistry among dental professionals to manage these issues effectively. The knowledge, and perceptions of training received related to dental implant among dental students and general practitioners (GPs) was decided and cross-sectional study was conducted with 212 GPs and 186 final-year dental students, totalling 398 respondents. A questionnaire comprising 11 questions (7 on basic knowledge, 2 on perceptions of training, and 2 on preferred training strategies) was administered. Data were analysed using descriptive statistics and chi-square tests with SPSS (version 26). The majority of students (61.3%) and GPs (50.5%) reported being moderately informed about dental implants, with a significant difference in knowledge levels (p=0.04). A smaller proportion of students (22%) and GPs (28.8%) considered themselves well-informed. A substantial 69.6% of respondents felt they received insufficient information on implant-based procedures, and 95% desired more information during their undergraduate studies. Regarding preferred training methods, 45% favoured a modular or one-year course led by implant experts. General practitioners have a higher knowledge level of dental implants compared to final-year students. However, both groups reported inadequate training during their undergraduate education and expressed a preference for additional training, particularly through modular courses. Enhancing the dental curriculum to include specialized, expert-led training modules could bridge the knowledge gap and improve competency in implant dentistry.
KEYWORDS: Dental implants, General practitioners, Implants, Tooth replacement, Knowledge, Oral health awareness, Missing teeth, Questionnaire, Oral health awareness.
INTRODUCTION:
Implant dentistry has emerged as a leading field in oral rehabilitation, offering predictable and functional solutions for replacing missing teeth.1,2,3 As the demand for implant-supported treatments continues to grow, it is crucial to ensure that dental professionals have the necessary knowledge and skills. This is especially important for final-year dental students and general practitioners, who are pivotal in delivering implant-based care.3,4
The acquisition of knowledge and the development of a predilection towards implant dentistry among final-year dental students and general practitioners are essential for determining the quality of care provided to patients. Enhanced knowledge in implant dentistry not only improves treatment planning and execution but also enables practitioners to address complications and achieve successful treatment outcomes effectively.5,6
The research goal is to assess the current information and inclination towards implant dentistry among final-year dental students and general practitioners in Klang Valley in Malaysia. By examining educational curricula and training programs in dental schools, as well as continuing education opportunities for general practitioners, this study seeks to identify deficiencies in implant dentistry education. Additionally, it aims to explore factors that influence the inclination toward teaching implant dentistry among these professionals.7
Understanding the current state of knowledge and inclination towards implant dentistry, teaching is crucial for identifying areas for improvement and developing targeted educational interventions.8,9 the application of using virtual reality and its tremendous use in the dental field. VR helps in training dental surgeons, interns and students in minimal invasive surgery By evaluating existing educational frameworks and assessing the perceptions and preferences of dental students and general practitioners in Klang Valley, this research can contribute to enhancing the quality and effectiveness of implant dentistry education. Addressing knowledge gaps and encouraging a focus on implant dentistry teaching can strengthen the foundation of implant education and ultimately improve patient outcomes.8,9,10
In the subsequent sections of this research report, an analysis of the current state of knowledge and inclination towards implant dentistry among final-year dental students and general practitioners in Klang Valley will be elaborated. This will include an overview of existing educational approaches, an assessment of the level of knowledge and confidence in implant dentistry, and an exploration of factors influencing the inclination towards teaching implant dentistry.11
MATERIALS AND METHODS:
A cross-sectional study was carried out by distributing survey forms to 5th-year dental students and general practitioners in Malaysia's Klang Valley region.
Sample size determination:
Calculation of sample size was done using statulator.com. Based on the calculation for a population size of 4482, the sample size of the study after considering 10% of expected missing data was 389 with a confidence level of 95% and 5% margin of error.
Sampling method:
Stratified random sampling method was used, in which all clinical year students from fifth-year dental students of various private and public universities in Klang Valley, Malaysia and general practitioners in Klang valley with a total of 389 willing respondents were invited to take part in the study.
Data collection:
The questionnaire consisted of 11 questions with 7 items aimed to obtain the knowledge level about dental implant, 2 questions on perception of knowledge acquired during undergraduates and 2 questions on strategies to receive training. Each question contained 5 alternative options and participants must select the single best answer. The questionnaire was adapted from a study carried out with undergraduate dental students at the University of Barcelona by Mª Angeles Sánchez-Garcés with author’s approval. Responses were received through hard copy questionnaires and google form.
Statistical analysis:
The data was collected, checked and analysed using the SPSS version 26. Descriptive statistical analysis was performed to calculate the frequency and percentage of the qualitative variables. A Chi-square test was performed to assess the differences in proportions for each question between final-year students and general practitioners, with statistical significance defined as p< 0.05.
RESULT:
Table 1: Distribution of responses according to their occupation.
|
Respondent |
Frequency |
Percentage |
|
Final year student |
186 |
46.7 |
|
General practitioner |
212 |
53.3 |
|
Total |
398 |
100.0 |
The total number of final-year dental students and general practitioners in Klang Valley is 4482. 500 questionnaires were distributed and 398 responses were received, giving the response rate of 79.6%. Out of the 398 total responses, 212(53.3%) were general practitioners and 186(46.7%) were final-year dental students.
Table 2: Knowledge and perception about dental implants among final-year students and general practitioners in Klang Valley
|
S. No |
Questions |
Final year |
General practitioner |
P -value |
|
H 1.
|
How well do you think you are informed about dental implants? a) Very Well b) Well c) Moderately d) Poorly e) Not at all |
5 (2.7) 41 (22.0) 114 (61.3) 26 (14.0) 0 (0.0) |
16 (7.5) 61 (28.8) 107 (50.5) 28 (13.2) 0 (0.0) |
0.040 |
|
2. |
O On a scale of 1-10, how difficult do you think it is to place an implant compared with other dental procedures? a) Very Easy b) Average c) Difficult d) Very Difficult e) Cannot say |
0 (0.0) 27 (14.5) 93 (50.0) 58 (31.2) 8 (4.3) |
3 (1.4) 105 (49.5) 74 (34.9) 15 (7.1) 15 (7.1) |
<0.001 |
|
3. |
What do you believe are the main advantages of dental implants compared with other prosthetic rehabilitations? a) Esthetic (more attractive than conventional prosthetics) b) More conservative (do not require dental preparation) c) Longer lasting d) No additional advantages e) Cannot say |
27 (14.5) 27 (14.5) 120 (64.5) 5 (2.7) 7 (3.8) |
12 (5.7) 107 (50.5) 77 (36.3) 5 (2.4) 11 (5.2) |
<0.001 |
|
4. |
What do you believe is the most important factor affecting implant success? a) Selection of case b) Type of implant c) Patient adherence to advice and recommendations d) Surgical technique e) Surgeon’s experience |
99 (53.2) 16 (8.6) 37 (19.9) 13(7.0) 21 (11.3) |
171 (80.7) 1 (0.5) 12 (5.7) 14 (6.6) 14 (6.6) |
<0.001 |
|
5. |
5. How would you inform patients as to the length of duration of treatment by implants? a) 2-5 years b) 5-10 years c) 10-20 years d) For life e) Cannot say |
3 (1.6) 42 (22.6) 84 (45.2) 44 (23.7) 13 (7.0) |
5 (2.4) 50 (23.6) 98 (46.2) 18 (8.5) 41 (19.3) |
<0.00 1 |
|
6. |
6. Do you believe dental implants need greater hygiene maintenance and care by the patient and dentist? a) No, hygiene needs are the same as for natural teeth. b) Yes, they call for greater care than natural teeth. c) No, they need less care than natural teeth. d) It depends on the risks to which the patient is subject (periodontitis, diabetes, etc.) e) Cannot say |
25 (13.4) 97 (52.2) 6 (3.2) 58 (31.2)
0 (0.0) |
45 (21.2) 99 (46.7) 1 (0.5) 67 (31.6)
0 (0.0) |
0.040 |
|
7. |
Do you think that dental implants offer an acceptable solution to tooth loss in this country? a) Yes, implants will always have a place in treatment planning. b) This depends on the educational level of the patient. c) No, the economic cost will limit their use. d) No, it is a too invasive treatment to be easily acceptable to the patient. e) No for other reason |
106(57.0) 28 (15.1) 45 (24.2) 6(3.2) 1 (0.5) |
140 (66.0) 23 (10.8) 45 (21.2) 2(0.9) 2 (0.9) |
0.211 |
Responses for each question by final students and general practitioners were presented in the tables above. Table 2 showed the knowledge and perception of dental implants among final-year students and general practitioners in Klang Valley, Malaysia. The majority of the final year students (61.3%) and general practitioners (50.5%) reported themselves to have a moderate level of knowledge regarding dental implants. However, 22.0% of final-year students and 28.8% of general practitioners believed themselves to be well-informed.
Regarding the difficulty of placing an implant, 50% of final-year students and 34.9% of general practitioners believed that the treatment was difficult, with a significant difference between the two groups. 49.5% of general practitioners felt that it is of average difficulty while 31.2% of final year students perceived it as a very difficult procedure.
Additionally, more than half of the general practitioners (50.5%) thought implants to be more conservative procedures than other prosthetic rehabilitation procedures, while only 14.5% of final-year students shared this perspective. However, 64.5% of final-year students regarded the implant as a longer-lasting treatment. In response to the question as to the primary factor affecting implant success, 80.7% of general practitioners thought that case selection affects the most on implant success, with 53.2% of final-year students shared this view. (p<0.001).
In terms of the longevity of the implant, 46.2% of general practitioners and 45.2% of final year students would inform patients that the implant can last for 10-20 years and 23.7% of final year students mentioned that implant can last for life while only 8.5% of general practitioners believed so. With regard to how the respondents saw implants as an acceptable solution for edentulism, 57% of final year students and 66% of general practitioners believed implants will be one of the treatment planning of replacing missing teeth in Malaysia with no significant difference observed.
Table 3: Predilection in teaching implant dentistry between final-year dental students and general practitioners in Klang Valley.
|
1. |
Have you received sufficient information about implant-based treatment procedures as part of the dental degree course syllabus? A. Yes B. No |
121 (30.4) 277 (69.6) |
|
2 |
Would you like to receive more information about implant-based treatment procedures as part of the dental degree course syllabus? A. Yes B. No |
378 (95.0) 20 (5.0) |
|
3
|
From which source would you prefer to receive more information about implant-based treatment procedures as part of the dental degree course syllabus? A. Short programs and workshops provided by private business (2-3 sessions). B. Certificate of aptitude obtained via a 1-year course or modular course imparted by dentists or implant dentistry experts. C. Books and specialized journals. D. Specialist consultants who could be contacted by students (tutors). E. Web-based teaching/learning platforms/groups. |
99 (24.9) 179 (45.0)
20 (5.0) 63 (15.8) 37 (9.3) |
|
4
|
From which source would you prefer to receive teaching and training in implant-based treatment procedures? A. Short programs and workshops provided by private business (2-3 sessions) B. Certificate of aptitude obtained via a l-year course or modular course imparted by dentists or implant dentistry experts. C. Postgraduate courses organized by the university. D. Specific courses during the degree course in dentistry E. Master’s programs (one-year full-time, or 2 years part-time). |
79 (19.8) 165 (41.5)
45 (11.3) 62 (15.6) 47 (11.8) |
The majority of the respondents (69.6%) claimed that they received insufficient knowledge on procedures involving dental implants. 95% of the respondents expressed the desire to acquire more information during undergraduate. 45% of total respondents preferred to receive training through a modular or 1-year course by implant experts as a part of the dental degree course syllabus. However, the least favorable learning option by both groups was university-organized postgraduate courses with only 11.3% of the respondents chosen this option.
DISCUSSION:
According to research done by Shivani et al. in 2014 in Malaysia, out % of 1013 respondents, 76.2% were aware of dental implants. This can be attributed to the rising interest in dental treatment among the younger generation and evolving attitudes towards medical and dental technology advancements.12
According to the result of this study, most final-year students (61.3%) and general practitioners (50.5%) reported having a moderate level of knowledge regarding dental implants. This might be attributed to a lack of focus on dental implants in the current curriculum in Malaysia.The SEI White Paper suggests that, in future, implant treatments will mainly be performed in general dental clinics (87.4 %) rather than in specialized implantology clinics (7.3%).13 It is crucial for recently graduated general dentists to have a solid foundation in implant dentistry to effectively assess indications for implant-based treatment and provide accurate information to patients regarding the risks and benefits involved. As dental implants are often done in clinics that provide integrated dental care, it becomes even more important for dentists to be well-prepared to handle these responsibilities from the start of their professional practice. By including implant dentistry in undergraduate education and ensuring that graduates have the necessary knowledge and skills, dental professionals can confidently offer this treatment option and provide the best possible care to their patients. Dentists should be well equipped to meet the demands of contemporary dental practice and contribute to the overall oral health and well-being of their patients.3,13
Moreover, more than half of the general practitioners (50.5%) thought implants to be more conservative compared with other prosthetic rehabilitation while only 14.5% of final-year students shared this perspective. Ken et al reported that 32% of patients declared the more conservative nature of dental implants to be the reason for choosing implant-based treatment. General practitioners have more exposure to prosthetic rehabilitation cases than final year students, thus the difference in perception on dental implants. Another research done by S.Jivraj et al. mentioned that dental implants are a more conservative long term option when compared with other fixed partial prosthesis as reduction of tooth structure is unnecessary, reducing the endodontic sequelae.14,15
In terms of longevity of dental implants, implant studies frequently reported outcome rates exceeding 95%. Meta-analyses found success rates of 96.7% to 97.5% for single-unit restorations and 92.5% to 93.6% for fixed partial restorations over 6 to 7 years.16 A large-scale study described cumulative survival rates of 92% for 13,049 two-stage implants over 15 years and 85% for 5,515 one-stage surgery implants over 10 years, including early failures.17
Regarding the question of the most significant element affecting implant success, 80.7% of general practitioners believed that case selection affects the most on implant success, with 53.2% of final-year students shared this view. Sonal Raikar et al. also stated that bone quality, region of implant and age of patient are the factors that determine implants’ survival rates. The study showed that maximum implant failures (55) were seen in the age group above 60 years and the group of age less than 40 years old happened to have least implant failure (20). Whereas the group age between 41 and 60 years gave a moderate number of implant failure (45). It has been seen that when patients' age increases, the failure rate tends to increase18. A report by leoney et al says that the fabrication of customized implant abutments is a viable option if the original abutments have been lost due to abutment screw failure, thereby favouring the treatment with implant even if the implant system is unknown19. With the innovation and application of using virtual reality, its tremendous use in the dental field helps in training students, interns and dental surgeons in order to practice as many times they want and improve their skills to the next level20
The majority of respondents (69.6%) reported having insufficient information about dental implant-supported procedures. A study reached the same conclusion, validating that there is some confusion and lack of understanding of indications and risk factors. Certainly 100% of participants concluded their knowledge was insufficient and 78.8% of the graduates accepted that they had not received sufficient teaching or training in implant dentistry
The field of dental implantology has seen a remarkable advancement in recent years, with increased success rates and widespread adoption.
CONCLUSION:
In conclusion, this research study highlights a notable difference in the knowledge level of dental implants between final year dental students and general practitioners in the Klang Valley. It is evident that general practitioners typically have a greater level of knowledge about dental implants than final-year students. This discrepancy emphasises the need for a standardised implant dentistry education for dental students to bridge the gap and ensure that they are adequately prepared to provide implant-based care upon graduation.
Both final year dental students and general practitioners in Klang Valley expressed a strong desire to enhance their knowledge, preference, and clinical experience in implant dentistry. Modular courses are perceived as an effective means of acquiring advanced knowledge and clinical skills, as they provide focused and practical training that can be integrated into busy professional schedules. It is crucial that final year dental students receive adequate exposure to implant-related concepts, techniques, and patient management, thereby equipping them with the necessary skills for successful implant treatments.
Addressing the difference in knowledge level between final year dental students and general practitioners is crucial for ensuring the delivery of high-quality implant-based care. By implementing standardised curricula and providing accessible modular courses, we can support the professional development and continuous learning of dental professionals. This, in turn, will enhance the overall knowledge, preference, and clinical experience in implant dentistry, ultimately leading to improved patient outcomes and satisfaction
CONFLICT OF INTEREST:
The authors have no conflicts of interest regarding this investigation.
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Received on 25.09.2024 Revised on 23.01.2025 Accepted on 28.03.2025 Published on 02.05.2025 Available online from May 07, 2025 Research J. Pharmacy and Technology. 2025;18(5):2275-2280. DOI: 10.52711/0974-360X.2025.00326 © RJPT All right reserved
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