Discrepancy between theoretical knowledge and self-perceived clinical competence in immediate implantation and immediate loading among dentists in Türkiye: a cross-sectional study

This study aimed to evaluate dentists’ knowledge of immediate implantation and immediate loading protocols, to assess their self-perceived clinical competence in this field, and to examine the relationship between theoretical knowledge and self-perceived clinical competence. A cross-sectional questionnaire study was conducted among general dentists practicing in Türkiye. A total of 258 dentists participated. The questionnaire comprised 21 items assessing demographic characteristics, knowledge (9 multiple-choice items), clinical preferences, and professional opinions. Data were collected online between 5 November 2024 and 23 January 2025 from a convenience sample recruited via e-mail and social media. Each correct knowledge response was scored 10 points (maximum attainable score = 90). Internal consistency of the nine dichotomously scored knowledge items was assessed with the Kuder–Richardson 20 (KR-20) coefficient. Statistical analyses were performed with IBM SPSS v26 and Python 3.11 (pandas, scipy, statsmodels), including descriptive statistics, independent-samples t-test, one-way ANOVA with Tukey’s HSD post hoc test, Pearson’s chi-square test, Spearman’s rank correlation, and linear and ordinal logistic regression (α = 0.05). The mean knowledge score was 58.72 ± 22.72 (of 90; median = 70). Knowledge score did not differ significantly by gender (independent-samples t-test, p = 0.061). Younger dentists demonstrated significantly higher knowledge scores (one-way ANOVA, F(3,254) = 25.04, p < 0.001), with the 24–30-year age group scoring highest. Self-perceived clinical competence was collected using a 5-point Likert item and collapsed into three categories: 42.2% ( n = 109) of participants reported feeling competent, 29.1% ( n = 75) were undecided, and 28.7% ( n = 74) reported feeling not competent. Contrary to the hypothesis that greater theoretical knowledge would be associated with greater self-perceived competence, an inverse relationship was observed: participants with the lowest knowledge scores most frequently reported feeling competent (60.0%), whereas this proportion was lowest among participants with the highest knowledge scores (35.9%) (χ²(6) = 13.09, p = 0.042, Cramér’s V = 0.16, indicating a weak-to-modest effect; Spearman’s ρ = −0.25, p < 0.001). This inverse association remained statistically significant, though modest in magnitude, after adjustment for age, gender, and workplace in a multivariable ordinal logistic regression model (adjusted odds ratio per 10-point increase in knowledge score ≈ 0.87, p = 0.024). In this sample, Turkish dentists’ theoretical knowledge of immediate implantation and immediate loading protocols was highly variable, and — contrary to expectations — higher theoretical knowledge was associated with lower, not higher, self-perceived clinical competence, a pattern consistent with a Dunning–Kruger-type miscalibration of self-assessment. Because competence was self-reported rather than objectively measured, these findings should be interpreted as evidence of a discrepancy in self-perception rather than of actual clinical skill. Educational strategies that pair knowledge transfer with structured, objective performance feedback may help improve the accuracy of self-assessment, particularly among less experienced practitioners. Given the cross-sectional design and convenience sampling, findings should be interpreted with caution and are not necessarily generalizable beyond this sample.