Exploring the Relationship Between Clinical Experience and CAD/CAM Adoption in Prosthodontic PracticesA CrossSectional Study
CAD/CAM; digital dentistry; prosthodontics; adoption; clinical experience; cross-sectional survey; training; technology implementation
AuthorsABSTRACTBackground: Computer-aided design and computer-aided manufacturing technologies have been increasingly integrated into prosthodontic workflows; however, adoption remains variable across clinicians and practice contexts. The current study examined whether clinical experience is associated with CAD/CAM adoption and sought to characterize utilization patterns and perceived implementation factors within prosthodontic practice. Methods: A web-based cross-sectional survey using an online, structured instrument was performed. Clinical experience was grouped as <5 years, 5–10 years, and >10 years. The main outcome measured was the adoption of CAD/CAM (adopter versus nonadopter). Secondary measures included experience with CAD/CAM in years and frequency, system familiarity, range of procedures, material usage, whether any kind of training had been received, and perceived facilitators/obstacles. The associations were tested by chi-square/Fisher's exact tests and Kruskal-Wallis tests, while independent predictors for adoption were tested by multivariable logistic regression (p < 0.05). Results: Of the 190 responses analyzed, 169 respondents were adopters (88.9%). Adoption varied by experience with χ²=12.10, df=2; p=0.003; Cramer’s V=0.25; adoption was lower among clinicians who have less than 5 years of experience at 80.5 percent compared with 5–10 years (96.6%) and >10 years (93.3%). In adopters, duration of CAD/CAM use significantly varied across experience strata (p<0.001), but not frequency of use (group comparisons: p=0.952; ordinal Kruskal–Wallis: p=0.985). In multivariable analysis, independent predictors of adoption included formal training (adjusted OR 24.01, 95% CI 4.93–116.92; p<0.001) and excellent self-rated knowledge (adjusted OR 10.25, 95% CI 2.35–44.62; p=0.002), whereas poor knowledge was inversely associated (adjusted OR 0.02, 95% CI 0.00–0.20; p<0.001). Conclusion: The adoption rate of CAD/CAM was high and associated with clinical experience in unadjusted analyses, but training exposure and knowledge level became the dominant independent predictors. In the case of adopters, experience primarily differentiated time since adoption rather than current use frequency, and implementation barriers differed between adopters and non-adopters in a manner consistent with pre-adoption resource constraints versus post-adoption operational challenges.
INTRODUCTIONCAD/CAM technologies have become integral to contemporary prosthodontic workflows, allowing for digital data acquisition, virtual design, and subtractive or additive fabrication of restorations with increasing efficiency and standardization. In particular, the maturation of chairside systems and integrated digital chains has transitioned CAD/CAM from a predominantly laboratory-based capability to a clinically deployable modality that may impact turnover time, quality control processes, and clinical decision-making in fixed prosthodontics. [8,10,11] Complementing these workflow-level advantages, broader digitalization of restorative dentistry has been promoted by ongoing advances in hardware reliability, software capability, and material science, expanding indications for digitally fabricated crowns and other fixed restorations. [8,9] ••••••••••••••••••••••••••••••••
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