The following section describes the key findings from the focus group discussion that studied the intention to adopt new technologies into clinical dental practice. The codes, categories and themes or domains derived from FGDs are presented in Table 2.
Focus Group Discussion
The participants were questioned on their familiarity and frequency of performing the peripheral tracing procedures using low fusing modeling compound for complete dentures. The participants were able to answer them easily and it built up their confidence and rapport with one other. This was particularly important to generate a rich data which helped in further discussions. Since the existing procedure was demonstrated since their undergraduate times, all the participants were very well familiar with them. Further, various challenges faced were discussed while performing the procedure. The key difficulties expressed by prosthodontists and general dental practitioners with the conventional procedure were that the procedure required time, patience and it was technique sensitive. They also expressed that the procedure takes time to learn for the beginners and even to learn the control and flow of the material. However, the procedure was more comfortable for trained dentists using the conventional material more than the advanced one. They further revealed that the advanced materials such as elastomeric impressions were expensive and the dentist must be accurate while performing the procedure as it takes less working time and mostly used in private practice. One of the faculty members further quoted on conventional techniques as follows:
“Most of the practitioners agree that the gold standard is still green stick. Even, for a beginner, for students, even today, we train them in green stick, we don’t train them with an elastomer. Because it is difficult to train them straightaway with an expensive material, it is always better to start off with green stick. Even all academic institutions recommend the same, I am sure clinically dentists do not begin their practice initially with elastomers, they begin with green stick and move on.”
Post-graduate students expressed that the technique is messy, difficult to control the flow of the compound, use of Bunsen burner often results in overheating and can burn patient’s and operator’s tissues. It is a time consuming procedure as it is a sectional technique, chipping or breakage often occurs in undercut areas such as disto-lingual sulcus due to its brittle nature of the modelling compound.
Performance Expectancy
Prosthodontists and general practitioners accepted that new technologies are useful in their daily practice if it improves their productivity. They conveyed that the new technology would explicitly reduce the time consumed and material wastage. It would be more useful for dental students to learn and improve their skills since the device maintains uniform thickness and was safer to use when compared with the conventional technique. The participants’ views expressed that the device would improve the performance convenience and that the procedure would reduce time as the material softened at a sooner rate. Some general practitioners however had consultant prosthodontists at their clinics who followed the traditional procedure of primary impression using alginate and secondary impressions using elastomeric materials.
Effort Expectancy
All participants of prosthodontists, general practitioners and post-graduate students suggested that an initial trial period was required to assess whether the device reduces efforts and improves precision.
Easy to Operate
All participants agreed on the fact that the device was easy to operate, as the time consumed was reduced. It’s easy for dental students to learn the skill as the device helped in temperature control and will reduce overheating of the material when used by the student.
Utility
The device according to the participants would mostly benefit teaching hospitals, in denture camps and in rural sectors. Post-graduate students suggested the device will be useful for dental clinics and for mid-year post-graduate students who are familiar with the conventional method more than a naïve undergraduate as he or she requires more time to be familiar with the procedure. One of the faculty members expressed and quoted as follows:
“Convenience is definitely improved using the device and academically, it will be of a very good advancement and help students. They would appreciate they may not burn their hands using the flame and a safer device and like our branch using the device.”
Thoughts and Observations
Before buying any new dental technology, the factors which concern dentists are cost, durability, and maintenance. The participants were concerned about the durability of the device for a minimum of 5 years, about the availability of spare parts, its user friendliness and safety for both patients and practitioners. The practitioners and post-graduate students were willing for a trial period to learn handling and working of the device. One of the expressions of
“We have just seen a small sample of it or working with it for a short period of time, so we don’t know how it performs when we work for a longer period of time, whether it will maintain the same efficiency. If it does, I am sure it will be an excellent substitute for conventional procedure of border molding”
Social Factors
Dentists were mostly influenced by their peers, consultants, key opinion leaders, company dealers and recommendation of faculty members at academic institutions. They expressed that seminars, literature, journals, attending conferences, workshops and exhibitions create awareness on new technologies in the market. Social media such as YouTube, WhatsApp, FaceBook and Instagram influence their choice of technology adoption. They also opined that the brand of the company dictates the quality of the product and their decisions is based on whether the product fetches value for money.
Technology Adoption Characteristics
Amongst the various factors that influence technology adoption, the important factors from a dentist’s point of view were the patient and practitioner’s convenience, efficiency, cost, service provided by the company of the device and time factor. The new technology should be convenient for the patient in terms of time consumed whereas for a practitioner it would be to improve her/his productivity and ease of operation. The acceptance of newer dental technologies majorly depends on cost, ease of operation and improved performance.
Descriptive Statistics
The demographic description of the 200 participants included the distribution of gender, age, location of survey, designation, material used for impression procedure and who performed the procedure have been shown in Table 3. 75 male and 125 female dentists responded to the study across Bengaluru, from various dental hospitals (n=25) and private dental clinics (n=175). Participants were between the age group of 20-29 years (n=40), 30-39 years (n=103), 40-49 years (n=50), and the least were among the age group of 50-59 years (n=7). 150 participants were majorly general practitioners followed by 41 prosthodontists (including both academicians (n=12) and prosthodontics (n=29)) and 9 were from other specialties. Most of the dentists used low fusing modelling compound (n=132), elastomeric putty impression material (n=31) and some used both the materials (n=37) while performing the impression procedure. 124 dentists performed the procedure by themselves whereas 57 dentists preferred a prosthodontist and 19 dentists preferred performing by themselves and a specialist.
Questions pertaining to the UTAUT2 Model were based on a five-point Likert scale measuring the 8 factors- Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonic motivation, Habit, Behavior and Buying Intention. The key findings are provided in Table 4. 88.5% of the dentists found the dispensing device to be useful in their daily practice whereas 75 % agreed to the fact that learning to operate would be easy for them. 72% of dentists considered the influence of key people for them to use the device whereas 66% of them considered the device to be compatible with other technologies they have used earlier. 67% of dentists thought they must use this new technology whereas 60% of dentists planned to use the dispensing device. 80.5 % of dentists were tempted to purchase this device if trial of this device was made available for a reasonable amount of time.
Discriminant Analysis
For discriminating adopters and non-adopters, the grouping (dependent) variable for two group discriminant analysis was “Intention to buy”. As “Intention to buy” was measured on a 5 point Likert Scale, it was necessary to convert it into a nominal scale. Hence, the people who “strongly agreed” and “agreed” to purchase were grouped together as likely adopters whereas the respondents who gave the “strongly disagree”, “disagree” and “neither agree nor disagree” were grouped together as likely non-adopters. Those who neither agreed nor disagreed were strongly assumed as non-adopters as they were indecisive about their stands. According to Discriminant Analysis performed, among 200 respondents, 161 respondents were found to be adopters and 39 as non-adopters. Table 5 presents the discriminating variables and their canonical discriminant function coefficients. The discriminant function was statistically significant (0.000) and the canonical correlation was 0.580. Wilk’s Lambda value was 0.664, further stating the discriminant function is significant. The results are further presented in Table 6 and in supplementary data.
The discriminant analysis was also able to predict the group membership with a particularly good level of classification accuracy of 84 % (in Supplemental Data). Classification accuracy is the ability of the model to correctly classify the individual cases into two groups i.e., adopters and non-adopters. Any value above 70 percent level of classification accuracy is accepted.51 Therefore, we conclude that the function “Intention to buy” is significant and there is a fair degree of discrimination between adopters and non-adopters.