Current adoption of the Prosthodontic Diagnostic Index for clinical care-A cross-sectional survey study

To assess current utilization of the Prosthodontic Diagnostic Index (PDI), identify perceived benefits and limitations, and evaluate support for future updates.

A survey regarding the use of the PDI was made available through email invitations to 68 US dental school prosthodontic/restorative department chairs (PD), 48 graduate prosthodontic program directors (GP), and 1834 private practice prosthodontists (PP) from the American College of Prosthodontists (ACP) member database. The results of this initial survey were inconclusive due to low response rates. The survey was also administered during the 2024 ACP Annual Session with an improved response rate for educators. Descriptive statistics were used to analyze responses from predoctoral education programs and graduate prosthodontic programs.

Responses were received from 43.8% (n = 21) graduate prosthodontic programs (GP) and 35.3% (n = 24) predoctoral programs (PD). The PDI was taught to graduate prosthodontic residents at 100% (n = 21) of the responding programs and at 58% (n = 14) of responding predoctoral programs. In contrast, the response rate for private practice prosthodontists, 2% (n = 43), was too low for statistical analysis. The PDI was used for new patient screening in 76.2% (n = 16) of GP and 41.7% (n = 10) of PD programs. The PDI was valued for enhancing diagnostic consistency (81.0%, n = 17 GP and 83.3%, n = 21 PD) and objective patient screening (90.5%, n = 19 GP and 87.5%, n = 21 PD). Common themes were observed in open-ended questions regarding the limitations of the PDI, including that the system was cumbersome, complicated, time-consuming to use, issues with calibration across all cohorts, and lacked recognition by general dentists and other dental specialists. The majority of respondents agreed that the PDI needs an update (76.2%, n = 16 GP and 66.7%, n = 16 PD), including the development of an ACP-endorsed classification system for implant-based treatment (81.0%, n = 17 GP and 91.7%, n = 22 PD).

The PDI is viewed as a beneficial diagnostic and educational tool in academic settings. However, it is complex and has limited alignment with contemporary prosthodontic practice. A revision of the classification system could address current limitations and better support clinical decision-making.