Treatment Planning Challenges in Prosthodontics: Conventional Fixed Versus Implant-Supported Prosthodontics: A Cross-Sectional Survey of Dental Practitioners in Libya

Abstract

This cross-sectional survey evaluated treatment planning preferences, perceived barriers, and self-reported clinical confidence among practicing dentists in Libya choosing between conventional fixed dental prostheses (FDPs) and implant-supported rehabilitations. Among 76 valid responses, practitioners strongly preferred implant-supported restorations in five of six clinical scenarios, including single missing posterior teeth (90.8%), single missing anterior teeth (81.6%), free-end saddles (76.3%), full-arch edentulism (71.1%), and 3–4-unit spans (55.3%). Conventional FDPs were preferred only when adjacent teeth required restoration (50.0% vs 43.4%). Experienced clinicians (>10 years) showed significantly higher implant preferences for full-arch edentulism (87.5% vs 50.0% for <5 years; p = 0.001) and compromised abutment cases (52.1% vs 27.8%; p = 0.039). Early-career dentists perceived inadequate bone volume as a greater obstacle than senior peers (mean 3.61 vs 2.92; p = 0.021). Highest-rated implant barriers were patient systemic health contraindications (mean 3.37), patient cost (3.14), and inadequate bone volume (3.09), whereas long-term biomechanical risk (2.72) concerned fixed prosthodontic options. Self-reported confidence in treatment planning was moderate for fixed prosthodontics (2.93) and implant therapy (2.92), with no significant differences by qualification level. Although 78.4% completed continuing education (CE) in implant dentistry, a marked desire for further training remained (3.43). In conclusion, participating dentists preferredimplant-supported rehabilitations, but clinical adoption remains constrained by patient-related factors and an ongoing need for hands-on, competency-based training.