ISSN No: 2582-0559

KNOWLEDGE, ATTITUDE AND PRACTICE OF DENTAL IMPLANTS

AMONG DENTAL PRACTITIONERS- A REGIONAL SURVEY

Dr. Balaji. V. R, Dr. Manikandan. D, Dr. Soundariya Bala Muralei

Department of Periodontology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India.

Address for Correspondence:

Dr.Soundariya Bala Muralei, Postgraduate Student,

Department of Periodontology,

CSI College of Dental Sciences and Research, Madurai,

Tamil Nadu, India.

Email id: sound28perio@gmail.com

Received:

20.02.2021

First Published:

19.03.2021

Accepted:

16.03.2021

Published:

27.03.2021

ABSTRACT

BACKGROUND:

To assess and compare the level of

knowledge, awareness and practice of dental implants among
dental practitioners in Madurai region through a questionnaire
survey.

MATERIALS AND METHODS:

A structured questionnaire

survey was done to assess the level of knowledge, attitude and
practice of dental implants among the dental practitioners
through Google form. Two interviewers with dental background
did the study, for a period of 4 months. Questions were structured
with close-ended and open-ended questions.

RESULTS:

76 participants recorded their responses for this

survey.  Out  of  76  participants,  76.3%  of  responders  were
practicing  dental  implants.  Upon  assessing  the  years  of
experience, 28% of responders  with 1-3  years of practice  were
more interested towards implant dentistry. 63.2% of practitioners
had undergone an implant course and the predominant source of
knowledge is through books and basic implant course.

CONCLUSION:

This survey reflects the current scenario of the

practicing dentist, who are updating and upgrading to emerging
dental science such as dental implants. Those who had less than
3 years of experience displayed more positive attitude towards
dental implants. Majority of dental practitioners despite having
good knowledge about dental implants preferred other treatment
options due to cost effectiveness of implant therapy.

KEYWORDS:

Dental implants, Dental practitioner, Web-based

questionnaire and Cross-sectional survey.

ORIGINAL ARTICLE

DOI:1.37841/jidam_2021_V8_I1_03

Balaji et al:

Knowledge, Attitude and Practice of Dental Implants Among Dental Practitioners

Volume No:

8, Issue No: 1

ISSN No: 2582-0559

INTRODUCTION

Implant dentistry has become an excellent modality in

replacement of missing teeth as it achieves the goal
regardless of the cause of change in the stomatognathic
system.

Ground reality of the clinical practice is based on

the clinician’s knowledge about a treatment and the patient’s
affordability  towards  the  treatment.  With  increase  in
evidence-based dentistry, a dental practitioner’s willingness
to  constantly  update  his  knowledge  and  attitude  towards  a
treatment modality influences the clinical practice per se. In
order  to  analyze  the  level  of  knowledge  and  practice,  a
questionnaire-based  survey  is  the  basic  platform  for
collection of information from public or professionals.

Hence, the aim of this present study evaluated the level

of knowledge and attitude about dental implants, their source
of knowledge and other dentist factors such as years of
experience, specialization and implant training on the same
using a web-based questionnaire.

MATERIALS AND METHODS:

A web-based cross-sectional survey utilizing a

structured questionnaire with multiple-choice questions was
conducted among practicing dental professional for a period
of four months. The purpose of this study was explained to
the participants and consent for the study was obtained. The
questions  were  structured  in  order  to  evaluate  the  level  of
knowledge  concerning  dental  implants,  their  source  of
knowledge  and  years  of  clinical  experience.  Institutional
Ethical  Committee  approval  was  obtained  for  this  study.
(REF: CSICDSR/IEC/0060/2018).

The questionnaire consisted of 2 parts

PART-I- Basic demographic components

PART-II- Questions to elicit the knowledge, level of practice
and attitude of dental implants

The questionnaire consisted of both open-ended and closed-
ended questions.

PART I

Age:

Gender:

Years of Experience:

Qualification:

Locality:

PART II

1. Are you practicing implants in your clinic?

Yes no

2. If yes, how many years you are practicing?

1-3 years

3-6 years

More than 6 years

3. If no, why you don’t prefer implants?

Expensive

No awareness among patients

More inventory

Other reasons

4. Do you think whether implants will be the best treatment

option for your patients?

Yes no

5. What type of implants you are practicing?

Root form implants Basal implants

If others specify

6. Do you do any specialised treatment protocol?

Zygomatic implants

Pterygoid implants

All on four implants

Tilted implants

If others specify

7. Whether you prefer immediate loading or delayed

loading?
Immediate loading Delayed loading

8. If immediate loading why? Or if delayed loading why?

Immediate loading ______ Delayed loading_________

9. What is the time period for delayed loading in your

clinic?

3 Months 6 Months More than 6 Months

10. Whether any failure in implants you have encountered?

Yes No

11. If yes, what are the failures you have commonly

encountered?

Balaji et al:

Knowledge, Attitude and Practice of Dental Implants Among Dental Practitioners

Volume No:

8, Issue No: 1

ISSN No: 2582-0559

Positioning

error

surgical

error

prosthesis error

Occlusal interference

systemic disease

If others specify

12. If you do implants with consultants, what type of

consultants you prefer?

Periodontist

Oral surgeon

Prosthodontist

Self

Others, please specify

13. Do you prefer cantilever in implants?

Yes

14. If yes which area do you prefer? Please specify.

15. Have you undergone any implant courses?

Yes

16. If yes what is the type of course?

Basic course

Advanced course

Training abroad

Others, please specify

17. How would you like to update your knowledge?

Books Journals

Lectures

CDE program

YouTube

STATISTICAL ANALYSIS:

The data were analysed by Statistical Package for

Social  Sciences  (SPSS)  version  21.  All  the  data  are
represented in the form of tables and  graphs. Chi-square
test was used to assess the level of knowledge, source, and
years  of  experience  and  practice  of  dental  implants  in
clinical practice.

RESULTS:

The results from the present study provides

information about the attitude, knowledge, and practice of
dental implants among dental practitioners in Madurai
region.

A total of 76 responses were obtained in this survey.

Demographic data and questionnaire analysis were tabulated
in Table-1 and Table-2 respectively.

Figure-1 shows the percentage of dental practitioners
practicing dental implants in their clinic.

Figure 1: Percentage of Dental Practitioners practicing

Table-1 shows the demographic data of participants

Table-1: Demographic data of the participants

Age (years)
Minimum=23
Maximum=55

Mean±SD
36.37±7.187

Sex            n (%)
Female    13(17%)
Male        63(83%)

16.74

P value=0.7

Years of experience (years)
Minimum=1
Maximum=33

Mean±SD
36.37±7.187
X

802.909

P value=<0.05*

Specialty
BDS
MDS
Periodontist
Prosthodontist
Orthodontist
Endodontist
Pedodontist
Oral pathologist
Oral medicine and
Radiologist
Oral surgeon

n (%)
22 (29%)
54 (71%)
17 (22.3%)
5  (6.5%)
7  (9.2%)
6  (7.8%)
3 (3.9%)
3 (3.9%)
5 (6.5%)
7 (9.2%)

MDS with other special
qualification

3 (3.9%)

1078.159

P value=0.07

Balaji et al:

Knowledge, Attitude and Practice of Dental Implants Among Dental Practitioners

Volume No:

8, Issue No: 1

ISSN No: 2582-0559

Figure-2 represents the specialist preferred by dental
practitioners for placement of dental implants.

Figure 2: Specialist preferred by practitioners

Figure 3 represents the source of knowledge about

dental implants

Figure 3: Source of knowledge by practitioners

The following Table 2 shows the Question-wise analysis

Question

Responses

P value

Are you practicing
implants in your
clinic?

Yes = 76.3

No= 23.7

17.315

0.69

If yes how many
years you are
practicing?

1-3 years= 28.9
3-6 years= 23.7

More than 6

years= 23.7

82.719

0.04*

If you practice
implants in your
practice who is
placing implants?

Consultant=30.3

Myself=35.5

38.588

0.62

What type of dental
implants you are
practicing?

Root form=63.2

Basal=10.5

Other =2.6

78.629

0.08

Do you practice
specialized
treatment protocol
like, [zygomatic
implants]

Yes=15.8

No=84.2

26.98

0.1

Do you practice
specialized
treatment protocol
like, [tilted
implants, pterygoid
implants]

Yes=14.5

No=85.5

18.39

0.6

Do you practice
specialized
treatment protocol
like, [all on four]

Yes=32.9

No=67.1

27.42

0.1

Do you practice
specialized
treatment protocol
like, [all on six]

Yes=26.3

No=73.3

20.911

0.4

Whether you prefer
immediate loading
or delayed loading?

immediate

loading=10.5

delayed

loading=72.5

27.29

0.9

Whether any failure
in implants you
have encountered?

Yes=42.1

No=36.8

44.843

0.3

Do you think
whether implants
will be the best
option for your
patients?

Yes=69.7

No=13.2

31.584

0.87

Speciality

Periodontist

Prosthodontist

Oral surgeon

Trained dentist

Books

Journals

Lecture

CDE programs

Basic implant

course

Advanced implant

course

Training

abroad

Source of Knowledge

Balaji et al:

Knowledge, Attitude and Practice of Dental Implants Among Dental Practitioners

Volume No:

8, Issue No: 1

ISSN No: 2582-0559

what is the time
period for delayed
loading in your
clinic?( mention for
maxilla and
mandible)

Maxilla :

1-3 months=2.3

3-6

months=92.4

More than 6

months =5.3

Mandible:

1-3

months=75.2

3-6

months=23.5

More than 6

months =1.3

566.33

1.0

Have you ever
undergone any
implant course
(basic or
advanced)?

Yes=63.2

No=27.6

44.494

0.3

Source of your
knowledge?
(Books, Journals,
lectures, CDE
programs)

Yes=73.3

No=26.3

20.911

0.4

Table 2: Questionwise Analysis

Figure 4 represents the reason for not preferring dental
implants

Figure 4: Reason for not preferring dental implants

DISCUSSION:

Replacement of lost dentition has been a prime factor

for an individual to approach a specialist or dentist. A survey
conducted by Rasika Manori Jayasinghe et al in 2017
concluded that majority of people (

76.2%)

are aware of

different types of teeth replacement options.

[3]

Dental

implant therapy has become a predictable treatment option
for edentulous ridges. It has become a day-to-day of every
general as well as speciality dental practice.

The results of this survey provides some insight into the
daily clinical practice. Factors such as the dentist's years of
experience,  implant  training,  and  specialization  also  affect
the  knowledge,  attitude,  and  practice  of  dental  implants.
Dental  practitioners  with  less  than  3  years  of  experience
displayed  best  knowledge,  positive  attitude,  and  the  most
practice for implants. A study conducted by Eckert et al. in
2012  observed  that  younger  Prosthodontists  expressed  a
greater desire to surgically place implants.

Dental practitioners with longer years of experience

still prefer conventional methods as a choice for the
replacement of missing teeth. Majority of responders (67%)
reported that cost is the main reason for not preferring dental
implants in their practice. Chaudhary et al., 2013 reported in
his study that high implant cost and patient’s fear for surgery
were limiting factor.

Educating ourselves in a newer frontier always

increases  our  attitude  and  perception  towards  the  concept.
Undergoing a training for implant enhances the knowledge,
provides  a  good  attitude,  and  increases  the  practice  of
implants.  Lang-Hua  et  al.  in  2013  conducted  a  study  to
compare  the  knowledge,  attitude  towards  dental  implants
among  dentist  who  received  implant  training  and  who  did
not,  the  results  are  in  accordance  with  the  present  survey
where  dental  practitioners  with  implant  training  had  a
superior knowledge and exhibited a positive attitude.

Maalhagh-Fard et al. in 2002 reported that a

stronger positive correlation among graduates who have
completed implant training as elective.

In this survey,

Prosthodontist  were  preferred  consultants  for  placing
implants among dental practitioners. This might be due to the
concept  of  prosthetic  derived  implant  placement  for  better
patient  related  outcomes.  However,  placement  of  dental
implant  is  always  as  a  multidisciplinary  approach.  Dental
implant  placement  is  always  a  team  work  consisting  of  a
Prosthodontist,  Periodontist  and  Oral  Surgeons.  Therefore,
efforts  should  be  made  at  the  institutional  level  to  extend

67%

17%

Reasons

expensive

I do only my specialty
practice,

no awareness among
patients

Balaji et al:

Knowledge, Attitude and Practice of Dental Implants Among Dental Practitioners

Volume No:

8, Issue No: 1

ISSN No: 2582-0559

implants' knowledge, attitude, and practice with other
streams as well.

Within the limitation of the study i.e. a small sample

size  and  regional  assessment,  it  can  be  suggested  that
budding  dental  practitioners  are  more  diverse  in  accepting
newer  treatment  approaches  and  showed  more  positive
attitude.  However,  experience  in  dental  practice  influences
the level of knowledge and practice of dental implants. With
better communication between various specialities and with
the  patient,  implementation  of  dental  implants  in  daily
practice is predictable and achievable.

CONCLUSION:

The knowledge and practice of implants by dental

practitioners in this southern region is still limited and there
is  a  need  to  improve  this  scenario.  Despite,  many  dental
practitioners practicing implant dentistry it is identified that
cost and lack of skills are prime factors preventing dentists
from  practicing  implant.  One  among  them  is  cost
effectiveness, hence an effort must be made to educate both
the  patient  and  the  practicing  dentist.  The  current  study
shows  that  there  is  an  increased  need  for  incorporating  the
basic knowledge and skill related to implant dentistry at the
undergraduate level to develop awareness about this branch
of  dentistry.  Though  this  survey  was  conducted  within  a
limited  group  of  people,  large  scale  studies  are  needed  to
know  the  level  of  implant  dentistry  practiced  and  various
problems  encountered  in  implant  dentistry  by  the  dental
practitioners in future.

FINANCIAL SUPPORT AND SPONSORSHIP

Nil

CONFLICTS OF INTEREST

There are no conflicts of interest.

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