Insight and Thoughts of Clinical Undergraduate Dental Professional Students Towards Dental Implants for Replacement of Missing Teeth: A Preliminary Study

¹Associate Professor, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

²Intern, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

³Post Graduate Student, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

⁴Professor, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

⁵Professor and Hod, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

⁶Professor, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India

*Corresponding Author: Dr. Kalamalla A SaranBabu, Associate Professor, Narayana Dental College and Hospital, Nellore, Andhrapradesh, India, Tel: 8886078222, Email: [email protected]

Received Date: June 06, 2025

Published Date: July 01, 2025

Citation: SaranBabu KA, et al. (2025). Insight and Thoughts of Clinical Undergraduate Dental Professional Students Towards Dental Implants for Replacement of Missing Teeth: A Preliminary Study. Mathews J Dentistry. 9(1):57.

Copyrights: SaranBabu KA, et al. © (2025).

ABSTRACT

Background: Dental implants have emerged as a popular choice for replacing lost teeth, underscoring the necessity for aspiring dentists to be well-informed and ready. Assessing clinical undergraduate dental students' perceptions, understanding, and attitudes regarding dental implants at Narayana Dental College and Hospital in Nellore, India, was the goal of this study. Procedures: A cross-sectional survey was administered to 350 randomly chosen 20–30-year-old, third-, final-, and intern students. A standardized, self-administered questionnaire modified from earlier, verified research was used to gather data. The survey evaluated demographic information, perceptions, knowledge, and perceived obstacles related to implant dentistry. Descriptive statistics and percentage distribution were used in the statistical analysis, with significance set at p < 0.05. Findings: Although awareness of dental implants as a treatment option varied by academic year, most students were aware of them. Many students thought that receiving treatment for implants was difficult and required a lot of upkeep. Longevity and durability were often mentioned benefits, while limited clinical exposure and budgetary limitations were noted as significant drawbacks. Conclusion: Although there was sufficient general knowledge about dental implants, undergraduate dental curriculum should include more clinical exposure and structured implant teaching to boost students' confidence and preparedness for clinical practice.

Keywords: Implant Rehabilitation, Dental Curriculum, Graduating Dentists, Undergraduate Students, Academics.

INTRODUCTION

Dental implants, which provide a long-lasting and efficient way to replace lost teeth, have emerged as a key component of contemporary dentistry [1]. The ever-increasing demand, awareness and publicity of these implants over conventional FPD through various modes of communication like printed media, Television, newspapers, friends and acquaintances etc provoked the public in search of the dentists (primary source of information) for enquiring and gathering sound information about implant procedures [2,3]. Before startup of any dental treatment, the common insight of every patient is to have a complete knowledge of treatment protocols like risk factors, advantages & disadvantages, consequences, financial expenses etc. Hence, for guiding a patient in appropriate manner towards implant dentistry, most of developed countries introduced pre doctoral dental implant education even in undergraduate dental schools [4].

With the ongoing improvements in implant technology, there is an increasing need for dental students to build a solid foundation in implantology to ensure effective patient results. Dental education must incorporate case selection, surgical methods, and long-term maintenance knowledge in order to properly place implants. Different academic dental training phases have varying levels of implantology knowledge. While third-year and final year BDS students start looking into its clinical applications, first- and second-year students mostly learn theoretical information through lectures. As they approach professional practice, especially interns should have a more thorough awareness of implant operations, including prosthetics, surgical placement, and patient assessment.

Undergraduate dental students in their clinical years are transitioning from theoretical learning to hands-on patient care. Their insight, attitude, and confidence towards advanced treatments like dental implants not only shape their current academic development but also influence their future clinical decision-making and patient communication. However, studies have shown that many undergraduate students may lack adequate exposure, practical confidence, or awareness of treatment planning considerations related to implants. Knowledge about indications, contraindications, procedural steps, maintenance, costs, and long-term outcomes of implants is vital for appropriate case selection and patient counselling. Moreover, a positive perception and willingness to learn more about implantology are key factors that determine how ready students are to adopt this modality in practice.

The knowledge and attitudes of dental students about dental implants have been examined in a number of studies, highlighting the need for improved teaching strategies. Only a small amount of research, nevertheless, has systematically compared knowledge levels across academic years. Recognizing gaps and guiding curriculum modifications can be achieved by understanding how students' knowledge changes over time. With this comprehensive knowledge towards implant treatment protocols, fresh dentists who are graduating in various dental schools will have sound information of implant treatment thereby evoking the patients in reach out of implant dentistry [5,6].

Henceforth, insight and thoughts of clinical graduating dental professional students towards implant dentistry who are attending in Narayana Dental College and hospital, Nellore, Andhra Pradesh, India have been evaluated. By identifying gaps in understanding and perception, this study can help inform curriculum development and guide enhancements in implant education at the undergraduate level.

MATERIALS AND METHODS

Study Participants and Design

The knowledge and attitudes of dental students regarding implant dentistry will be evaluated at Narayana Dental College and Hospital through a cross-sectional survey study. To choose participants, a simple random selection method will be used. A total of 350 clinical undergraduate dental professional students both males and females (3^rd, 4^th and Interns between the ages of 20 & 30 years) India were included in the study.

Data collection

Data will be gathered using a self-administered structured questionnaire. The entire questionnaire was developed based on a literature review and a previous study by Chaudhary et al. [7,8]. Two sections will comprise the questionnaire, which will be modified from earlier validated studies:

a) Demographic Data: Age, sex, academic year, and educational attainment.

b) Insight-based questions: Basic knowledge about implant treatment, clinical indications, advantages, and limitations

c) Perceptions and Knowledge about Dental Implants: Closed-ended questions about knowledge, perceptions, Confidence in recommending implants, willingness to pursue implant training, information sources, and obstacles to implant treatment will be included in the second half.

d) Awareness-based questions: Familiarity with implant brands, cost, and clinical procedures

e) Procedure for Data Collection (Convenience sampling Method): All qualified students at Narayana Dental College and Hospital will receive the questionnaire via Google Forms.10 to 15 minutes is the expected time needed to complete the questionnaire.

The questionnaire was pilot tested on 30 students for clarity and reliability (Cronbach’s alpha = 0.80).

f) Ethical Considerations: Approval was obtained from the Institutional Ethics Committee. Participation was voluntary and anonymous, and digital informed consent was secured. (IEC/NDCH/2023/AUGUST- SEPTEMBER/P- 87)

g) Analysis of Data: Sample size calculations were performed using stastical software G^* power version. A Power of 0.95 at a 95% confidence level with 0.05 requires sample size of 341.The key findings will be presented using descriptive statistics including the mean, standard deviation, and percentage frequency distribution. To evaluate the relationship between educational attainment and dental implant knowledge.

- Responses were compiled in Microsoft Excel and analyzed using SPSS version XX.

- Descriptive statistics (frequency, percentage) were used for categorical variables.

- Chi-square test was used to compare responses based on academic year.

- A p-value of <0.05 was considered statistically significant.

Inclusion criteria

a) Interns, final-year students, and third-year students. between the ages of 20 and 30 years

b) Being prepared to take part and give their informed consent.

Exclusion criteria

a) Pre-clinical students (1^st and 2^nd year)

b) Incomplete or duplicate responses

c) Students with prior implant dentistry specialist training.

d) Individuals who decline to take part or do not finish the survey.

RESULTS

A total of 341 of the 350 clinical undergraduate students were participated in the survey, resulting in a response rate across the academic years; interns=27.85%, Final BDS=33.72%. Third BDS=38.41% (Table 1 & 2). Third-year students, final-year students, and interns made up the responders, with [insert distribution] being between the ages of 20 and 30.

Most participants (81.2%) responded that they were aware about the implant replacement option for missing teeth. The respondents of about (77.5%) confirmed that implant option for replacement of missing teeth is bringing change in terms of selection of treatment protocols for clinical oral rehabilitation and (69.3%) pledged that this treatment modality as acceptable solution for oral rehabilitation in our country. Moreover, (70.3%) students stated that public awareness & Patient acceptance for implant treatment modalities is increasing in day-to-day practice.

Most respondents (68.6%) listed "longevity, durability & success" as the main advantage of dental implants over conventional FPD;(69.7%) responded that there is need of "Multidisciplinary approach of different specialities for implant treatment; (74.5%) stated that “systemic health factors “plays a pivot role in diagnosis and selection of implant option and (62.6%) students believed that age factor influences in selection of implant treatment option. Most of the surveyed students (75.3%) reported that evaluation of bone density is important during implant surgery. Nevertheless 58.6% of surveyed students are aware of osseointegration importance for implant treatment modalities.

About (66.1%)of respondents concurred that, in comparison to natural dentition, implants require more careful dental hygiene and maintenance. Most of the respondents (61.1%) throughout undergraduate studies, recognized the complexity of implant placement and categorized it as a "very difficult" or "moderately difficult" process. 66.8% surveyed students also believed that this implant rehabilitation requires elaborative surgical procedures, more radiographic investigations.

Similarly, about 69.3% respondents, economic feasibility was cited as a major hurdle for patients in India, and financial restraints were often mentioned as a barrier to implant acceptance in clinical practice. Additionally, many students 57.6% reported not knowing enough about different types of implant systems, implant materials and equipment’s used for implant surgery. This factor made the freshly graduated students to initial outlay needed to start a private clinic offering implantology services.

Table 1. Distribution of the study sample according to Level of education

Table 2. Relationship between the knowledge of dental implants and the student’s perception

Introduction of dental implants, as a treatment modality, for rehabilitation of one or more missing teeth has revolutionized the clinical scenario of modern dentistry due to its high predictability and popularity. Before startup of any treatment, the common insight of every patient is to enquire and have a complete knowledge of treatment protocols like risk factors, advantages & disadvantages, durability, longevity, consequences, financial expenses etc. Fresh dentists who are graduating in various dental schools should have sound information of implant treatment thereby evoking the patients in reach out of implant dentistry. Hence, for guiding a patient in appropriate manner towards implant dentistry, Academic-based knowledge and proper attitude towards implant dentistry should be included in the minimum acceptable level of a graduating dentist. Moreover, many countries in Asia assessed to observe the level of knowledge, attitude, and perceptions of their dental students toward implant dentistry and addressed upgrading or adding implant dentistry in their undergraduate curricula [9-11].

Most of the entire questionnaire in our study was developed based on a literature review of previous study by Chaudhary et al [7]. Primarily in the first section of the questionnaire, level of knowledge and perception of the students about dental implants was selected for this study. The current study reveals a range of perspectives and knowledge regarding dental implantology among Narayana Dental College and Hospital clinical undergraduate students. These results align with previous studies, which indicated that while knowledge improved with academic advancement, it still lacked depth in important clinical areas. The results of the initial investigation offer significant comprehension of the present dental implantology knowledge, attitudes, and readiness of clinical undergraduate dentistry students. Since dental implants are still the best option for replacing lost teeth, it is vital that aspiring dentists are knowledgeable about and skilled in this field.

Most of the students 61.1%, believed that dental implant treatment is “very difficult”, challenging and intricate process. This most likely stems from a lack of organized, preclinical training in implant procedures as well as restricted clinical exposure. Without enough opportunity to watch or participate in real implant surgeries, the majority of students mostly rely on didactic sources, such as lectures and textbooks. Without this experience, students would feel unprepared and unconfident about their ability to comprehend the meticulous procedures required in prosthetic planning, implant insertion, and postoperative care [10]. Many of the students, 66.1% agreed that dental implants require continuous oral maintenance and more monitoring after placement. They believed that comprehensive maintenance protocol should be followed for long durability and success of the implant. They replied that there should be additional oral hygiene maintenance and care by the patient and dentist [12,13]. It's also critical to highlight that although students demonstrated a reasonable understanding of implant hygiene requirements, many were unsure of the extent of postoperative care required. Some of the responses showed the false belief that implants would need the same or less care as natural teeth. This emphasizes how crucial it is to emphasize the significance of peri-implant care, possible side effects, and patient compliance in order to guarantee long-term implant success.

Additionally, it was determined that one of the main concerns with implant dentistry was its cost. According to a number of students 69.3%, the high expense of implant therapy may prevent many Indian patients from using it. The financial outlay necessary to integrate implantology into private practice, including setup fees, surgical equipment costs, and procurement prices, was also noticeably lacking. This reveals a significant educational gap: students, particularly those planning to enter private practice, need to be educated about the business and administration facets of implant dentistry in addition to being clinically prepared.

The lifespan of dental implants was one of the benefits that respondents mentioned the most. Students of 68.6%valued implants as a solid and long-lasting substitute for conventional fixed partial dentures. This knowledge demonstrates a fundamental conceptual understanding of the therapeutic advantages of implants. One systematic review stated that cumulative survival rates of dental implants were 94.6% after a follow-up period of at least 10 years (mean 13.4 years). Krebs et al. analyzed the outcomes of ANKYLOS dental implants up to 20 years follow-up, and it was found that a high cumulative survival rate of 93.3%. The majority of the students, especially final years and interns, answered the most appropriate answer in our study [14,15].

However, a sizable percentage of students voiced skepticism when asked about the technical difficulty, upkeep requirements, and patient management associated with implant installation. The entire range of clinical factors involved, such as long-term prosthetic maintenance, surgical procedures, and patient selection criteria, were not well understood by many students. According to the response proportion, final year students have higher knowledge levels than 3^rd and 4^th year. Some students responded as “do not know,” and it can be assumed that they had insufficient knowledge about dental implants. This suggests that there should be more focus on integrated learning, which blends classroom instruction with discussions of real-world cases and practical experience.

Afsharzand et al. [4] in 2002 conducted a study to evaluate the teaching philosophies, curricular structure, and materials used in in European dental schools for conducting predoctoral implant dentistry courses. These schools in Europe stated implant courses in1999 and most of the Prosthodontists are found teaching the implant courses in some dental schools. Even though predoctoral implant courses were not started, they used to teach implant related theory topics in some restorative and/or prosthodontic courses. Moreover, in North America and Europe; Majority of the schools have started providing dental implant courses before 2000 [11].

Solid introduction and knowledge foundation in implant dentistry by the Dentists working as university educators were critical in bringing the integration of implant-related learning content into undergraduate education [16]. It can also be seen that some dental schools have separate dental implant departments for enhancement of implant education in developed and some developing countries.

Australian Osseointegration Society in 2007 developed a statement on aims and objectives of undergraduate dental education there by bringing the “best practice in implant dentistry, “which although purposed primarily for the dental practice [17]. In most of dental hospitals associated along with teaching of undergraduate students; most of the 3rd bds, final bds students are not involved in treating patients with dental implants whereas interns’ assistance is being promoted to be present during implant surgeries. However, Moeini G et al conducted a study recently and confirmed that theatrical knowledge gained in implant education was not strong enough to practice and they all are in seek of further practical training in placement of implants [18].

Compared to India, Implant related lectures and some laboratory work of implant prosthetics were first added to the undergraduate curriculum in 2012 in most of the European, UK & Australian countries. Nevertheless, in India, implant surgery protocols and prosthetics are being incorporated into postgraduate curriculum particularly for prosthodontics, periodontics, and oral surgery departments. However, due to ever growing demand and growth of implants treatment in general day to day routine clinical practice, recent graduating students are being focused to show more interest in showcasing dental implant education in their academic curriculum [19]. Henceforth, combination of didactic-clinical exposure of implant surgeries-laboratory procedures is becoming inevitable in their predoctoral programs [4].

In our study, the fact that most participants indicated a desire to learn more about implants and their clinical applications is encouraging. This optimistic outlook points to a solid basis for more sophisticated and organized schooling. Implantology can be better taught in dental schools by include it sooner in the curriculum and improving it through interactive modules, workshops, and clinical demonstrations. Considering insights, thoughts, awareness & perception of implants practice, it may be concluded that early implementation of dental implant education particularly when the students enter into clinical years [3^rd &4^th bds] into their academic curriculum, will be beneficial to their general dental practice once they encroach into regular clinical practice after completion of their BDS [20].

Despite of all the positive feedback with regards to implementation of dental implant education in the academic curriculum of undergraduate students, major barrier to the progression of the program might be financial expenses (75%), followed by time limitations imposed by the curriculum (37%), and liability insurance (37%) [21]. Moreover, elaborative gender wise and year wise analysis also to be carried out. Never though with regards to future perspective, stronger statistical analysis methods need to be implemented than simple percentage frequency distribution and the opinion of general dental practitioners or dental professionals towards predoctoral implant dentistry curriculum survey should be recorded.

CONCLUSION

In summary, clinical undergraduate students have a basic level of knowledge about dental implants, but there is still much space for improvement in terms of thorough comprehension and preparedness for practice. To prepare students for the growth and demand of clinical scenario of implants in modern dentistry, the curriculum needs to be reevaluated with an emphasis on clinical integration, multidisciplinary education, and exposure to real-life implant situations.

REFERENCES

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QUESTIONNAIRE

1. Are you aware about implant treatment modality for rehabilitation of missing teeth?

a. Yes

b. No

c. May be

d. Don’t know

2. If yes do you think Implant treatment modality is acceptable solution for oral rehabilitation in our country?

a. Yes

b. No

c. May be

d. Don’t know

3. Do you think Implant treatment modality is bringing change in terms of selection of treatment protocol of oral rehabilitation in clinical scenario of modern dentistry?

a. Yes

b. No

c. May be

d. Don’t know

4. Do you think Public awareness and patient acceptance of implant treatment modality for oral rehabilitation is increasing daily in general clinical practice?

a. Yes

b. No

c. May be

d. Don’t know

5. Do you think implant modality is more advantageous than Conventional FPD in terms of longevity, success, Durability etc.?

a. Yes

b. No

c. May be

d. Don’t know

6. Do you think a multidisciplinary approach of different dental specialties is required for implant treatment modalities?

a. Yes

b. No

c. May be

d. Don’t know

7. Do you think role of systemic health factors is must in selecting implant treatment modality?

a. Yes

b. No

c. May be

d. Don’t know

8. Are you aware of different types of implant systems, implant materials and equipment used for these procedures?

a. Yes

b. No

c. May be

d. Don’t know

9. Do you think type of bone, bone density is important in selection of implant treatment modality?

a. Yes

b. No

c. May be

d. Don’t know

10. Do you think cost of implant treatment is more expensive, time taking procedure?

a. Yes

b. No

c. May be

d. Don’t know

11. Do you think implant treatment modality requires more oral hygiene maintenance than other modalities?

a. Yes

b. No

c. May be

d. Don’t know

12. Are you aware of Age factor will influence in selection of implant treatment modality

a. Yes

b. No

c. May be

d. Don’t know

13. Do you think procedures involved in implant treatment modality are more difficult compared to other modalities of oral rehabilitation?

a. Yes

b. No

c. May be

d. Don’t know

14. Do you think implant treatment modalities requires elaborative surgical profiles, radiographic investigations?

a. Yes

b. No

c. May be

d. Don’t know

15. Are you aware of osseointegration in implant treatment modalities?

a. Yes

b. No

c. May be

d. Don’t know