Patient Expectations and Dentists' Perceptions of Those Expectations in Dental Implant Therapy: A Mirror-Design Study

Oral healthcare succeeds not only when treatment is biologically sound but when its outcome meets patient expectations, making expectation management a measurable component of care quality. Patient satisfaction in dental implant therapy is strongly influenced by pre-treatment expectations, yet differences between patient expectations and dentists' perceptions of those expectations remain poorly characterized. This study compared the two using a mirror-design survey.

A cross-sectional survey was administered to adult patients (n = 250) and dentists involved in implant therapy (n = 200). A 16-item questionnaire was developed in two parallel versions covering two domains, outcome expectations and surgical process apprehension, rated on a 5-point Likert scale. Internal consistency, item- and subscale-level differences, and signed and absolute between-group difference scores were analyzed.

Significant between-group differences were identified in 13 of the 16 items, while total scale scores did not differ between groups, producing a cancel-out effect at the aggregate level. Within the surgical process apprehension domain, patients were more optimistic than dentists perceived, with procedural pain showing the largest between-group difference (Cliff's δ = 0.437). The opposite pattern emerged for long-term outcomes, where concern about implant loss yielded the largest difference across the entire instrument (δ = 0.645). Dentists' clinical experience was negatively correlated with the signed total gap score (ρ = -0.342, p < 0.001), indicating reduced directional bias among more experienced clinicians.

Patients' expectations differed systematically from dentists' perceptions of those expectations across both domains, but these opposing differences offset at the aggregate level. Aggregate summary scores may therefore obscure clinically relevant item-level differences, and directional item-level analyses may better capture expectation patterns in implant dentistry.