Knowledge, attitudes, practices and clinical preparedness regarding porcelain laminate veneers among dental interns

Abstract

Background

In recent years, increasing aesthetic expectations have led to a growing demand for porcelain laminate veneer treatments. This study aims to address a gap in the literature by evaluating the knowledge, attitudes, and practices of undergraduate dental students regarding porcelain laminate veneers, within the context of updated dental curricula, thereby providing insight into their current level of theoretical understanding and clinical preparedness.

Methods

This study employed a descriptive cross-sectional design. The sample consisted of final-year students from the Faculty of Dentistry at Atatürk University. A total of 150 students were invited to participate; those who agreed and completed the questionnaire in full were administered a KAP-based survey adapted for porcelain laminate veneer applications.

Results

A total of 134 dental interns participated in the study, of whom 61.9% were female and 38.1% were male. Based on objective assessments, the level of theoretical knowledge was found to be high, with correct response rates ranging between 85% and 94% for many items; however, lower success rates were observed in technically demanding aspects, such as cement thickness effects on shade selection (28.4%) and preparation classifications (45.5%). Subjective evaluations revealed limited clinical experience and self-confidence; notably, only 32.1% of participants had encountered a laminate veneer case in clinical practice. While no significant difference was found in theoretical knowledge levels by gender (p = 0.083), male participants demonstrated significantly higher self-perceived clinical confidence scores compared to females (p = 0.024). A weak negative correlation was observed between objective knowledge scores and self-perceived clinical confidence scores (r = -0.201, p = 0.020).

Conclusions

Despite a high level of theoretical knowledge among dental interns, this theoretical knowledge was not reflected in students’ self-perceived clinical preparedness and confidence. Furthermore, a weak negative correlation was identified between objective knowledge and self-perceived clinical confidence scores, suggesting these constructs are related but distinct. These findings highlight the need to strengthen simulation-based training, clinical case exposure, and complication management within undergraduate prosthodontic education.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-09863-8.

Background

Conservative treatments that prioritize natural tooth structure preservation have become central to modern aesthetic dentistry, with porcelain laminate veneers emerging as one of the most widely adopted minimally invasive options [1]. Although often perceived as a recent innovation, laminate veneers date back to the 1930s, when Charles Leland Pincus first applied thin ceramic shells using temporary adhesives in the American film industry; limited luting systems of the era, however, precluded long-term stability [2]. Consisting of ceramic layers typically 0.2–0.5 mm in thickness, these restorations closely replicate the optical properties of natural teeth and exhibit high color stability [3, 4], while demonstrating favorable periodontal biocompatibility and consistently successful long-term outcomes [5, 6].

The primary indications for laminate veneers include tetracycline staining, amelogenesis imperfecta, fluorosis, diastema, morphological anomalies, surface defects due to erosion or abrasion, post-traumatic discolorations, and fractured incisal edges [7–9]. Conversely, parafunctional habits, poor oral hygiene, high caries incidence, severe crowding, and edge-to-edge occlusion are recognized contraindications [10, 11]. The key advantages of porcelain laminate veneers include minimal tooth preparation, excellent color stability, and superior aesthetic outcomes; however, technical sensitivity, difficulty of repair, and relatively high costs remain notable limitations [12]. Clinical success depends on accurate diagnosis, appropriate preparation design, adherence to adhesive protocols, and correct cementation technique [13], with porcelain fracture and chipping representing the most frequently reported failure modes [14, 15].

The clinical workflow encompasses shade selection, tooth preparation with labial reduction of 0.4–0.7 mm within enamel boundaries [16, 17], gingival margin design terminating supragingivally or at the gingival level to preserve bonding potential [18], and gingival retraction prior to impression [19]. Feldspathic porcelain, leucite-reinforced and lithium disilicate glass ceramics, and high-translucency zirconia represent the principal material options [20–23]. Adequate resin cement polymerization is essential for restoration longevity [24], and while cement color and opacity influence the final shade outcome [25, 26], evidence on the direct effect of cement thickness on final color remains insufficient [27].

Treatment outcomes are ultimately dependent on the clinician’s knowledge, clinical experience, and decision-making skills [28]. The Knowledge–Attitude–Practice (KAP) framework provides a structured approach to evaluating these competencies, encompassing theoretical understanding of materials and protocols, professional attitudes toward veneer use, and practical implementation in clinical settings [29–31]. Despite the growing prevalence of laminate veneer restorations, evidence regarding dental interns’ KAP in this domain remains scarce. The present study therefore aims to assess the knowledge, attitudes, and practices of final-year dental interns at Atatürk University Faculty of Dentistry regarding porcelain laminate veneer restorations.

Methods

Human ethics approval and consent to participate

Ethical approval for this study was obtained from the Atatürk University Scientific Research and Publication Ethics Committee (Document date and number: 27/06/2024–06/2024-44). The study was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants prior to data collection. Participation was entirely voluntary. Data were collected anonymously; only age, gender, and academic year were recorded, with no personal identifying information collected. All data were securely stored and accessible only to the research team.

Research design and instrument development

This study employed a cross-sectional, questionnaire-based design. The survey instrument was developed within the Knowledge–Attitude–Practice (KAP) framework. Item generation was grounded in a systematic review of the existing literature and clinical guidelines on porcelain laminate veneers, ensuring that all objective items were directly supported by published evidence (see Background section for relevant references).

The questionnaire development followed a structured multi-stage process to establish face and content validity. In the first stage, an initial item pool was generated through a systematic review of the literature and current clinical guidelines on porcelain laminate veneers, ensuring that all items reflected evidence-based clinical content. In the second stage, face validity was established through review by a panel of 10 dental residents specializing in prosthodontics. Each panelist independently assessed all items for clinical relevance, representativeness, and linguistic clarity. Feedback from this review was consolidated, and items identified as conceptually redundant or unclear were discussed with a biostatistician. Following this process, one item was removed due to conceptual redundancy, yielding a final 21-item questionnaire comprising 14 objective and 7 subjective items.

The internal consistency of the final instrument was evaluated using Cronbach’s alpha coefficient, calculated separately for the objective and subjective subscales. The alpha coefficient was 0.796 for the objective subscale and 0.727 for the subjective subscale, indicating acceptable to good internal consistency for both subscales. Although the Cronbach’s alpha for the objective subscale should be interpreted with some caution -given that the items were intentionally designed to assess heterogeneous clinical knowledge domains rather than a single unidimensional construct- the obtained value nonetheless supports the overall reliability of the instrument. This pattern is consistent with findings reported in other KAP instruments assessing multidimensional knowledge [29]. The subjective subscale demonstrated acceptable internal consistency.

Study setting and participants

The study was conducted at the Faculty of Dentistry, Atatürk University, Erzurum, Türkiye. The target population consisted of fifth-year dental interns enrolled during the 2024–2025 academic year. This cohort was selected because fifth-year students represent the final stage of undergraduate dental training and are actively engaged in supervised clinical practice, making them the most appropriate group for evaluating the translation of theoretical knowledge into perceived clinical competence.

Sample size determination

Sample size adequacy was assessed a priori using G*Power (version 3.1.9.7). The expected effect size (d = 0.51) was derived from a KAP study with a comparable design, published prior to data collection [32]. Based on an independent samples t-test for two-tailed comparisons, a significance level of α = 0.05, and an allocation ratio of N2/N1 = 0.61 reflecting the unequal gender distribution of the sample, the minimum required total sample size to achieve 80% statistical power was estimated at approximately 132 participants. The final sample of 134 participants therefore met this criterion. Post-hoc power analysis confirmed an achieved power of 0.81, further supporting the adequacy of the sample size.

Data collection and procedure

A total of 150 dental interns were invited to participate. Printed questionnaires were distributed and collected during scheduled clinical rotations. Of those invited, 134 students returned fully completed questionnaires, yielding a response rate of 89.3%. Forms with missing or inconsistent responses (n = 16) were excluded to ensure analytical integrity.

Scoring system

Responses to objective items were coded as 1 (correct) and 0 (incorrect), and individual scores were summed to yield a raw total (range: 0–14). For subjective items, responses were coded as 1 (Yes) and 0 (No), yielding a raw total (range: 0–7). For comparability and ease of interpretation, scores on each subscale were converted to percentage scores based on the maximum possible score (14 points for the objective subscale and 7 points for the subjective subscale). On both subscales, higher percentage scores indicate a higher proportion of affirmative or correct responses; on the objective subscale, this reflects greater theoretical knowledge, and on the subjective subscale, this reflects greater self-perceived confidence.

Statistical analysis

Data were coded and analyzed using SPSS statistical software (version 27; IBM Corp., Armonk, NY, USA). Categorical variables were summarized as frequencies and percentages. Prior to parametric testing, normality was assessed by examining skewness and kurtosis values. The skewness value for the objective subscale was − 1.166 and the kurtosis value was 2.987; for the subjective subscale, the skewness value was 0.343 and the kurtosis value was − 0.885. Although the objective subscale showed some deviation from normality, reflecting a left-skewed distribution attributable to participants’ high knowledge scores, parametric analyses were considered appropriate given the sample size of 134, which confers sufficient robustness against moderate violations of normality. Between-group differences in scale scores were examined using independent samples t-tests for gender comparisons and one-way ANOVA for age group comparisons. The relationship between objective and subjective scores was assessed using Pearson correlation analysis. A p-value of < 0.05 was considered statistically significant.

Results

Demographic characteristics of the participants

The final study sample consisted of 134 dental interns, of whom 61.9% were female and 38.1% were male. The majority of participants (94.0%) were between 21 and 25 years of age. All participants were fifth-year students undergoing clinical internship training (Table 1).

Table 1.

Gender, age and grade distribution of the participants

Variable		Frequency	Percentage (%)
Gender	Female	83	61.9
	Male	51	38.1
Age	21–25	126	94.0
	26–30	7	5.2
	31–40	1	0.7
Grade	5th Year	134	100.0

Knowledge levels of participants regarding porcelain laminate veneer applications

The analysis of responses to objective items presented in Table 2 indicates that participants generally demonstrated a high level of theoretical knowledge regarding porcelain laminate veneers, with correct response rates exceeding 85% for most items, including indications, contraindications, advantages, disadvantages, ceramic material selection, and common complications and failure modes. Notably, correct response rates were also high for gingival preparation margin design (89.6%) and resin cement selection (86.6%), reflecting a solid foundational understanding of restorative principles.

Table 2.

Distribution of responses to objective knowledge items (n = 134, O = Objective item.)

Item	Correct		Incorrect
	Frequency	Percentage (%)	Frequency	Percentage (%)
O1. Conditions such as tetracycline discoloration, fluorosis, amelogenesis imperfecta, minimal malpositions, and diastema are among the indications for porcelain laminate veneers.	126	94.0	8	6.0
O2. Parafunctional habits such as bruxism, poor oral hygiene, high caries incidence, and the presence of severe crowding and rotations are contraindications for porcelain laminate veneers.	123	91.8	11	8.2
O3. Porcelain laminate veneer restorations can be safely applied in patients with edge-to-edge occlusion.	125	93.3	9	6.7
O4. The advantages of porcelain laminate veneers include minimal tooth preparation, high color stability, strong adhesive bonding to enamel, and resistance to tensile and shear forces.	115	85.8	19	14.2
O5. The difficulty of repair and the high level of technical sensitivity required during preparation are among the disadvantages of porcelain laminate veneers.	125	93.3	9	6.7
O6. Window-type preparation includes the incisal edge.	61	45.5	73	54.5
O7. The external contour of the tooth is not considered during facial preparation.	116	86.6	18	13.4
O8. The gingival preparation margin should follow the gingival contour.	120	89.6	14	10.4
O9. Gingival retraction is not necessary during the impression stage for porcelain laminate veneers.	107	79.9	27	20.1
O10. Commonly used materials for porcelain laminate veneers include glass ceramics, feldspathic ceramics, and oxide ceramics.	126	94.0	8	6.0
O11. Cement thickness does not directly affect shade selection.	38	28.4	96	71.6
O12. Light-cured or dual-cured resin cements are generally used during cementation.	116	86.6	18	13.4
O13. Surface glazing of the restoration contributes to long-term success.	126	94.0	8	6.0
O14. Fracture/chipping is not among the common failure modes of porcelain laminate veneers.	120	89.6	14	10.4

In contrast, notable knowledge gaps were identified in technically demanding areas. Correct response rates were considerably lower for preparation type classification (45.5%) and the direct effect of cement thickness on shade selection (28.4%).

Self-perceived clinical preparedness of participants

The analysis of subjective items presented in Table 3 indicates that participants’ self-perceived clinical confidence and preparedness were comparatively limited. Only 32.1% reported having encountered a laminate veneer case in clinical practice, and fewer than 27% considered themselves sufficiently knowledgeable about porcelain laminate veneers in general (24.6%) or their associated complications (26.9%). Confidence in preparation principles (34.3%) and cementation procedures (31.3%) similarly remained low. Relatively higher confidence was reported only for indication determination (54.5%) and preparation capability (53.7%).

Table 3.

Frequency distribution of responses to subjective items (n = 134, S = Subjective item.)

Item	Yes		No
	Frequency	Percentage (%)	Frequency	Percentage (%)
S1. Have you encountered a patient requiring porcelain laminate veneer treatment in clinical practice?	43	32.1	91	67.9
S2. Do you think you can accurately determine the indication for porcelain laminate veneers during clinical examination?	73	54.5	61	45.5
S3. Do you believe you have sufficient knowledge about porcelain laminate veneers?	33	24.6	101	75.4
S4. Do you have sufficient knowledge about the preparation of porcelain laminate veneers?	46	34.3	88	65.7
S5. Do you think you are capable of performing porcelain laminate veneer preparation?	72	53.7	62	46.3
S6. Do you consider yourself competent in the cementation procedures of porcelain laminate veneers?	42	31.3	92	68.7
S7. Do you have sufficient knowledge about complications associated with porcelain laminate veneers?	36	26.9	98	73.1

Gender-based differences in responses to objective items

According to Table 4, the mean objective knowledge score was higher among female participants (87.09%) compared to male participants (82.63%). However, this difference did not reach statistical significance (t(132) = 1.756, p = 0.083).

Table 4.

Independent samples t-test results for the objective scale according to gender

Variable		n	Mean	SD
Gender	Female	83	87.09	11.07
	Male	51	82.63	15.92
Statistical significance	t(132) = 1.756
	p = 0.083

SD Standard deviation

p > 0.05

Gender-based differences in responses to subjective items

As presented in Table 5, the independent samples t-test revealed a statistically significant difference in self-perceived preparedness scores between genders (t(132) = -2.290, p = 0.024). Male participants demonstrated a higher mean subjective score (43.98%) compared to female participants (32.36%).

Table 5.

Independent samples t-test results for the subjective scale according to gender

Variable		n	Mean	SD
Gender	Female	83	32.36	29.01
	Male	51	43.98	27.68
Statistical significance	t(132) = -2.290
	p = 0.024

SD Standard deviation

p < 0.05

Analysis of responses to objective items by age groups

According to the one-way ANOVA results presented in Table 6, there was no statistically significant difference in theoretical knowledge scores across age groups (F = 0.188, p = 0.666). As only one participant fell within the 31–40 age group, this group was excluded from the analysis to ensure statistical reliability.

Table 6.

One-way ANOVA results for the objective scale according to age groups

Variable		n	Mean	SD
Age	21–25	126	85.60	12.99
	26–30	7	87.76	7.94
Statistical significance	F = 0.188
	p = 0.666

SD Standard deviation

p > 0.05

Analysis of responses to subjective items by age groups

As shown in Table 7, the one-way ANOVA results revealed no statistically significant difference in self-perceived clinical confidence scores across age groups (F = 0.000, p = 0.984). As only one participant fell within the 31–40 age group, this group was excluded from the analysis to ensure statistical reliability.

Table 7.

One-way ANOVA results for the subjective scale according to age groups

Variable		n	Mean	SD
Age	21–25	126	36.51	29.11
	26–30	7	36.73	27.18
Statistical significance	F = 0.000
	p = 0.984

SD Standard deviation

p > 0.05

Correlation between objective knowledge and self-perceived clinical confidence

As presented in Table 8, Pearson correlation analysis revealed a statistically significant weak negative correlation between objective knowledge scores and self-perceived clinical confidence scores (r = -0.201, p = 0.020). Higher theoretical knowledge scores were associated with slightly lower self-perceived clinical confidence.

Table 8.

Pearson correlation analysis results for objective knowledge and self-perceived clinical confidence scores

Variable	r	p
Objective Knowledge (%)-Self-Perceived Clinical Confidence (%)	-0.201	0.020*

*p < 0.05.

Discussion

Although numerous studies have investigated knowledge, attitudes, and practices (KAP) in dentistry, no previous study in Türkiye has comprehensively evaluated dental interns’ knowledge and self-perceived preparedness regarding porcelain laminate veneer applications. The present study therefore aimed to investigate both the theoretical knowledge levels and perceived clinical preparedness of students at the clinical internship stage.

In healthcare professions, including dentistry, attitudes and self-confidence may influence professional motivation, satisfaction, and clinical engagement [33, 34]. Continuously updating dental curricula and clinical training in accordance with students’ evolving educational needs is therefore important for improving undergraduate preparation.

The present study included 134 fifth-year dental interns actively engaged in clinical practice, the majority of whom were female and between 21 and 25 years of age. The findings demonstrated that students generally possessed a high level of theoretical knowledge regarding porcelain laminate veneers. High correct response rates were observed for indications (94.0%), contraindications (91.8%), advantages (85.8%), disadvantages (93.3%), gingival preparation margins (89.6%), and ceramic material selection (94.0%), suggesting that students have acquired a substantial theoretical foundation during undergraduate education.

Knowledge regarding contemporary ceramic materials exceeded the 75% reported by Prath and Jain among practicing dentists (although this comparison study was published in a pharmacy-oriented rather than a dentistry-focused journal, and should therefore be interpreted with some caution) [30], which may reflect the increasing emphasis on adhesive and aesthetic dentistry in current curricula and earlier exposure to contemporary restorative materials. Knowledge regarding resin cement selection was similarly high (86.6%), indicating familiarity with adhesive cementation concepts. This pattern is consistent with observations that theoretical knowledge may decline without continuous professional development following graduation, underscoring the importance of lifelong learning in clinical practice.

However, lower correct response rates were observed for technically sensitive topics, including veneer preparation classifications (45.5%) and the influence of cement thickness on final restoration color (28.4%). Comparable findings have been reported previously [30], suggesting that advanced technical details may be more difficult for both students and clinicians to fully integrate into clinical decision-making. These findings indicate the need for greater curricular emphasis on technically demanding aspects of laminate veneer treatment during undergraduate education.

Students also demonstrated high awareness of complications and failure mechanisms (89.6%). Given that debonding and esthetic complications are among the most frequently reported veneer failures in the literature [32], this awareness may positively contribute to treatment planning and long-term restoration management.

Despite the high theoretical knowledge levels observed, students reported comparatively low perceived clinical preparedness and self-confidence. Importantly, this finding should not be interpreted as evidence of inadequate clinical competence. Rather, the findings reflect students’ self-perceived preparedness and confidence, which are conceptually distinct from objectively measured clinical competence.

Notably, the literature suggests that successful clinical outcomes may still be achieved by undergraduate students under appropriate supervision. Murphy et al. reported that 89% of laminate veneer restorations performed by undergraduate students remained complication-free at five years [35], while controlled preparation techniques have been shown to improve preparation quality even among inexperienced operators [36]. These findings highlight an important paradox: it is possible that students with lower self-confidence are nonetheless capable of achieving satisfactory clinical outcomes, suggesting that perceived preparedness and actual clinical performance may not always directly correspond, particularly within supervised educational environments. As the present study did not assess actual clinical outcomes, this remains a hypothesis to be tested in future research rather than a conclusion supported by the current data.

An alternative interpretation of this discrepancy warrants consideration. Students demonstrating strong theoretical understanding while simultaneously reporting lower clinical self-confidence may reflect appropriate professional self-awareness rather than educational inadequacy. Recognizing the boundaries of one’s own clinical experience -particularly for technically sensitive esthetic procedures- may represent appropriate calibration rather than a deficiency. This interpretation is consistent with findings from prospective studies in other dental disciplines, which have demonstrated that knowledge-confidence discrepancies are common early in clinical training and tend to diminish progressively with increasing clinical exposure [37, 38]. However, the present cross-sectional, questionnaire-based design does not allow these two interpretations to be distinguished: whether the observed knowledge-confidence discrepancy reflects appropriate clinical calibration or a genuine educational gap cannot be determined from the current data, and this remains an important question for future longitudinal or mixed-methods research.

The finding that a considerable proportion of students reported limited direct exposure to laminate veneer cases further contextualizes the observed self-confidence levels. Limited hands-on experience may partially explain lower perceived preparedness, particularly for procedures requiring proficiency in case selection, preparation design, shade management, and complication handling. Clinical self-confidence has consistently been shown to develop through repeated supervised patient care experiences [39, 40], and reduced clinical exposure has been associated with lower self-confidence levels [41, 42].

The clinical learning environment may independently influence students’ confidence development. Supportive supervision, structured feedback, and increased opportunities for patient management have been associated with improved self-confidence in undergraduate settings [39, 40]. Simulation-based education and expanded clinical case diversity have similarly been recommended to facilitate the transition from theoretical learning to clinical application [43, 44]. Increasing preclinical simulation exercises and diversifying esthetic restorative case exposure during undergraduate training may therefore represent meaningful curricular interventions.

A further contextual factor relevant to this study’s setting is the growing prominence of dental health tourism and high-volume esthetic dentistry in Türkiye. In such clinical environments, full-coverage restorations may be more frequently performed than minimally invasive laminate veneer procedures, potentially resulting in limited undergraduate exposure to conservative adhesive approaches. This clinical context may partially shape students’ treatment planning perspectives and their perceived preparedness regarding adhesive esthetic restorations.

Additionally, porcelain laminate veneers are increasingly visible in social media and digital esthetic dentistry content. Exposure to online clinical material may enhance students’ theoretical familiarity with veneer concepts beyond formal curricular instruction. However, such passive theoretical exposure does not necessarily translate into hands-on clinical experience or improved perceived preparedness. Furthermore, commercial esthetic trends mediated through social media may simultaneously elevate patient expectations, adding further complexity to the clinical environment in which students are trained [45].

Regarding demographic variables, no significant differences in theoretical knowledge were observed according to gender, whereas male students demonstrated significantly higher levels of self-perceived clinical confidence (p = 0.024). This finding is consistent with studies reporting higher clinical self-confidence among male students, which has been attributed to gender-related differences in self-assessment tendencies and risk tolerance in clinical decision-making [46, 47]. The absence of significant differences between age groups is likely attributable to the relatively homogeneous age distribution of the sample.

One of the most notable findings of the present study was the weak negative correlation observed between objective knowledge scores and self-perceived clinical confidence scores (r = -0.201, p = 0.020). This finding suggests that, while the two constructs are related, higher theoretical knowledge does not necessarily correspond to higher perceived clinical readiness. As objective knowledge and perceived self-confidence represent conceptually distinct dimensions of clinical preparedness, these results should be interpreted accordingly. The findings further suggest that theoretical knowledge acquisition alone may not be sufficient to generate perceived clinical readiness, particularly for technically sensitive procedures such as porcelain laminate veneer restorations.

Overall, dental interns demonstrated strong theoretical knowledge regarding porcelain laminate veneers, whereas their perceived preparedness for clinical application remained comparatively lower. These findings collectively highlight the importance of expanding simulation-based training, increasing exposure to diverse esthetic clinical cases, and strengthening instruction in technically demanding procedures and complication management within undergraduate prosthodontic education.

Limitations of the study

Several limitations should be considered when interpreting the findings of this study. First, the study was conducted at a single institution and included only fifth-year dental students, which may limit the generalizability of the findings to other dental schools or practicing dentists. Institutional curriculum characteristics may additionally have influenced students’ educational exposure and responses.

Second, the study relied on a self-reported questionnaire; therefore, the findings reflect perceived preparedness and theoretical knowledge rather than objectively measured clinical competence. Although content review procedures were performed by a panel of prosthodontic residents and a biostatistician, additional psychometric validation methods and broader multi-center validation would further strengthen the measurement tool.

Third, the cross-sectional design does not allow evaluation of how theoretical knowledge, clinical exposure, or self-confidence may change longitudinally throughout clinical education. Furthermore, the extreme imbalance in the age group distribution -with only one participant in the 31–40 age category- necessitated the exclusion of this subgroup from the age-based ANOVA, since a group reliably represented by a single observation does not permit a meaningful estimate of within-group variance or a statistically valid comparison with the other groups; age-based comparisons were therefore conducted only between the 21–25 and 26–30 age groups1. Detailed information regarding the number of veneer cases observed or performed by participants was also not comprehensively evaluated. Additionally, one objective item (O14) was phrased as a double negative (‘Fracture/chipping is not among the common failure modes…’), and despite the high correct response rate observed for this item, this phrasing may have introduced some interpretive ambiguity and should be revised to a more direct wording in future iterations of the questionnaire.

Finally, although the sample size was determined to be adequate through a priori power analysis, inclusion of participants from multiple institutions and with different levels of clinical experience would provide a broader understanding of undergraduate preparedness regarding porcelain laminate veneer restorations.

Conclusions

Within the limitations of this study, dental interns demonstrated high levels of theoretical knowledge regarding porcelain laminate veneer applications; however, this theoretical knowledge was not reflected in their self-perceived clinical preparedness and confidence. Because clinical competence was not objectively assessed, the findings should be interpreted as reflecting perceived preparedness rather than actual clinical performance.

The weak negative correlation observed between objective knowledge and self-perceived clinical confidence suggests that, while these constructs are related, theoretical understanding and perceived clinical preparedness may develop somewhat independently during undergraduate education. Increasing simulation-based training opportunities, expanding exposure to clinical cases, and strengthening education related to technically sensitive procedures and complication management may contribute positively to students’ perceived preparedness and confidence regarding laminate veneer applications.

Abbreviations

KAP

Knowledge, Attitude, Practice

SD

Standard Deviation

n

Sample Size

p

Probability Value

r

Correlation Coefficient

Authors’ contributions

N.Y., M.U.Y. and T.Ö. contributed to the drafting and preparation of the manuscript. M.U.Y. and T.Ö. collected and analyzed the data. The manuscript was drafted with contributions from all authors. All authors read, critically revised, and approved the final version of the manuscript.

Funding

The authors did not receive any specific funding for the study.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

The present study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Ethical approval was obtained from the Atatürk University Scientific Research and Publication Ethics Committee (Date: 27/06/2024, Number: 06/2024-44). All participants were fully informed about the study’s aims and procedures. Written informed consent was obtained from all individual participants included in the study. Participation was entirely voluntary, and data were collected anonymously to ensure confidentiality.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.