Journal of Prosthetic Dentistry
Research and Education| Volume 129, ISSUE 3, P448.e1-448.e8, March 2023

Three-dimensionally printed implant surgical guide-related experience, knowledge, attitude, and professional behaviors among 2028 dentists in China: A cross-sectional study

  • Aihemaiti Muhetaer
    Doctoral student, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
    Search for articles by this author
  • Hongye Yang
    Associate Professor, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
    Search for articles by this author
  • Yan Liu
    Doctoral student, Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, PR China
    Search for articles by this author
  • Cui Huang
    Corresponding author: Dr Cui Huang, Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan City 430079, PR CHINA
    Professor, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
    Search for articles by this author
Published:February 02, 2023DOI:


      Statement of problem

      Research on the current place of 3-dimensionally printed implant surgical guides (3D-ISGs) among practicing dentists worldwide is lacking, with little research focused on dentists’ experience, knowledge, attitude, or professional behavior related to 3D-ISG or on the main obstacle to adoption.


      The purpose of this cross-sectional study was to identify the adoption of 3D-ISG in dental practice in China and to determine factors that influence its further application and dentists’ attitudes and willingness.

      Material and methods

      Semistructured questionnaires were sent to a sample of Chinese dentists composed of users and nonusers of 3D-ISG. The questionnaires were displayed and distributed through a professional online survey system ( and a social media platform (WeChat). The responses were analyzed with multivariable generalized equations, and the effect of various demographic variables was determined, including dentist experience, academic degree, and type of practice (public or private).


      A total of 2028 valid questionnaires were collected. In dental practice, 39.3% of the respondents used 3D-ISG. Respondents with a PhD (62.4%) used the 3D-ISG more than twice as frequently as respondents with a junior college degree or below (31.8%). The majority of the members of implantology departments (81.7%) applied 3D-ISG, but doctors in other departments used it at a rate of less than half. The 3D-ISG was most frequently used in the maxillary anterior area (78.4%), followed by the edentulous maxilla and mandible (61.0% and 60.5%, respectively). The main barriers were high initial cost, complex and time-consuming digital design, and lack of expertise in the proper use of 3D-ISG.


      Most dentists did not use 3D-ISG in dental practice. The 3D-ISG application rate was significantly associated with sex, academic degree, years of dental practice, department, monthly income, and type of healthcare facility. To improve the popularity of 3D-ISG, particularly among dentists without advanced degrees, it would be important to optimize the digital design software program and provide sufficient training.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Howe M.S.
        • Keys W.
        • Richards D.
        Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis.
        J Dent. 2019; 84: 9-21
        • Ramanauskaite A.
        • Sader R.
        Esthetic complications in implant dentistry.
        Periodontol. 2000 2022; 88: 73-85
        • Chackartchi T.
        • Romanos G.E.
        • Sculean A.
        Soft tissue-related complications and management around dental implants.
        Periodontol. 2000 2019; 81: 124-138
        • Testori T.
        • Weinstein T.
        • Scutellà F.
        • Wang H.L.
        • Zucchelli G.
        Implant placement in the esthetic area: criteria for positioning single and multiple implants.
        Periodontol. 2000 2018; 77: 176-196
        • Liaw K.
        • Delfini R.H.
        • Abrahams J.J.
        Dental implant complications.
        Semin Ultrasound CT MR. 2015; 36: 427-433
        • Choi W.
        • Nguyen B.C.
        • Doan A.
        • Girod S.
        • Gaudilliere B.
        • Gaudilliere D.
        Freehand versus guided surgery: factors influencing accuracy of dental implant placement.
        Implant Dent. 2017; 26: 500-509
        • Guentsch A.
        • Sukhtankar L.
        • An H.
        • Luepke P.G.
        Precision and trueness of implant placement with and without static surgical guides: an in vitro study.
        J Prosthet Dent. 2021; 126: 398-404
        • Marei H.F.
        • Abdel-Hady A.
        • Al-Khalifa K.
        • Al-Mahalawy H.
        Influence of surgeon experience on the accuracy of implant placement via a partially computer-guided surgical protocol.
        Int J Oral Maxillofac Implants. 2019; 34: 1177-1183
        • Tack P.
        • Victor J.
        • Gemmel P.
        • Annemans L.
        3D-printing techniques in a medical setting: a systematic literature review.
        Biomed Eng Online. 2016; 15: 115
        • D'haese J.
        • Ackhurst J.
        • Wismeijer D.
        • De Bruyn H.
        • Tahmaseb A.
        Current state of the art of computer-guided implant surgery.
        Periodontol 2000. 2017; 73: 121-133
        • Tian Y.
        • Chen C.
        • Xu X.
        • et al.
        A review of 3d printing in dentistry: technologies, affecting factors, and applications.
        Scanning. 2021; 2021: 1-19
        • Dawood A.
        • Marti Marti B.
        • Sauret-Jackson V.
        • Darwood A.
        3D printing in dentistry.
        Br Dent J. 2015; 219: 521-529
        • Greenberg A.M.
        Digital technologies for dental implant treatment planning and guided surgery.
        Oral Maxillofac Surg Clin North Am. 2015; 27: 319-340
        • Cassetta M.
        • Bellardini M.
        How much does experience in guided implant surgery play a role in accuracy? A randomized controlled pilot study.
        Int J Oral Maxillofac Surg. 2017; 46: 922-930
        • Von Elm E.
        • Altman D.G.
        • Egger M.
        • et al.
        The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies.
        Int J Surg. 2014; 12: 1495-1499
        • Muhetaer A.
        • Yang H.
        • Zhao Y.
        • Huang C.
        A survey of application of digital technology in Hubei dental practice.
        J Oral Sci Res. 2021; 37 (Original language: Chinese): 1084-1088
        • Van der Zande M.M.
        • Gorter R.C.
        • Bruers J.J.M.
        • Aartman I.H.A.
        • Wismeijer D.
        Dentists' opinions on using digital technologies in dental practice.
        Community Dent Oral Epidemiol. 2018; 46: 143-153
        • Tran D.
        • Nesbit M.
        • Petridis H.
        Survey of UK dentists regarding the use of CAD/CAM technology.
        Br Dent J. 2016; 221: 639-644
        • Eisinga R.
        • Grotenhuis M.T.
        • Pelzer B.
        The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown?.
        Int J Public Health. 2013; 58: 637-642
        • Wang W.
        Medical education in China: progress in the past 70 years and a vision for the future.
        BMC Med Educ. 2021; 21: 453
        • McAdams C.D.
        • McNally M.M.
        Continuing medical education and lifelong learning.
        Surg Clin North Am. 2021; 101: 703-715
        • Cervero R.M.
        • Gaines J.K.
        The impact of CME on physician performance and patient health outcomes: an updated synthesis of systematic reviews.
        J Contin Educ Health Prof. 2015; 35: 131-138
        • Gamborena I.
        • Sasaki Y.
        • Blatz M.B.
        Predictable immediate implant placement and restoration in the esthetic zone.
        J Esthet Restor Dent. 2021; 33: 158-172
        • Buser D.
        • Martin W.
        • Belser U.C.
        Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations.
        Int J Oral Maxillofac Implants. 2004; 19: 43-61