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

BACKGROUND/OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.