Dental Implants Homepages:
Are they Educative?
A Cross-Sectional Study
Layla Abdel-Aziz Abu-Nabaa
BDS, PhD, MFDRCS
Department of Substitutive
oral sciences, college of
dentistry, Taibah University,
AlMadinah AlMonawwarah
KSA
Formerly Prosthodontic
Department, Jordan
University of Science and
Technology, Jordan
laylanabaa@hotmail.com
| 14 | Smile Dental Journal | Volume 6, Issue 4 - 2011
Abstract
Dental implant manufacturers web pages are presenting more links to educative
material targeting students, dental practitioners, technicians, and patients.
Aim: This cross-sectional study aims to describe the amount of links to educational and
scientific material in comparison with links to information, support services and other
web-based material using a standardized methodology.
Material and methods: A convenient sample of dental manufacturers web pages
was chosen. The ADA lists 39 companies in its dental buying guide IMPLANTS AND
ACCESSORIES CATEGORY in 2010. Icons present in the companies web pages are active
links, which linked the surfer to other web pages. The subsequent webpage was categorized
according to the material presented in it as: Educational and scientific materials,
Information materials, Services and support materials. Target audiences were described.
Results: This study shows that homepages focus on being directories, containing
variable numbers of clickable icons. Clicking them lead the reader to other web pages,
either containing the actual material of interest, or containing another directory of more
clickable icons. Types of material presented by the clickable icons on the homepages
of the sample, included a sum of 93 informative, 64 service related or supportive
and 85 lead to material described as educational. Three homepages represented a
comprehensive directory by including icons leading to all three materials categories(one
included a sum of 78 links, the second included 57 and the final had 42 links).
Conclusions: Within the limit of this cross sectional study, it is concluded that
educational material is considered as a major category of material presented by the
homepages of dental implant manufacturers.
Keywords: Dental Implants, Education, e-resources, Cross-sectional study, Internet.
Introduction
Internet became a preferred tool for enquiries, information gathering and
communications for many. Clinical skills of health professionals were enhanced by this
new learning behavior that evolved with the expanding use of the net. It helped surfers
to answer patient related questions, pharmaceutical inquiries, and update and follow
clinical developments.1
However, many experts involved in critical appraisals of internet-disseminated
materials, advocated professionals to perform informed searches and rely on evidence
derived from good research.2 They disseminated this message by spreading the word
through the internet!
Dental bodies also promote evidence-based dentistry and set guides for the learners
on how to judge the hierarchy of evidence. More and more educative material are
distributed by the internet as an instructional method, which proved better than traditional
methods.3 Now it is accepted to accumulate independent-study points from internet-
 ADA.org: Dental Buying Guide Page 1 of 2

based courses, as for continuation of dental practice Licensure | Catalog | Member Directory | Contact

licensure.4 Teledentistry, dental informatics and dental

portals, are subject which have developed into mature
branches of specialty, revolving around the internet DENTAL BUYING GUIDE

technology and the delivery of reliable knowledge.5-8 Introduction

Buying Guide Search
Listing in the Buying Guide
Contact the Buying Guide
New Dentist Resources

Implant manufacturers developed their web pages, Product Category Search Results for 'Implants and Accessories'

accordingly, to become more educative. An increasing 3i, Palm Beach Garden, FL

Ace Surgical Supply Co Inc., Brockton, MA

number of homepages contain dedicated sections for AIT Dental, Inc, Beverly Hills, CA
Aseptico Inc, Woodinville, WA

evidence and continual education. Some manufacturers ADA LIBRARY

ADA PUBLICATIONS
Asteto Dent Labs, Maplewood, NJ
Astra Tech, Inc., Lexington, MA
began investing in educational institutions which About ADA Publishing
ADA News Today
Attachments International, San Mateo, CA
Bicon Dental Implants, Boston, MA
prioritize research. Others have devoted funds, advisors
Advertise in
ADA Publications Bien Air USA, Irvine, CA
Advocacy Publications
Bio-Lok International, Inc., Deerfield Beach, FL
and publications which would help perform and later, Buying Guide
Classifieds Butler Company, John O., Chicago, IL

disseminate results of studies using their implant systems.

E-Publications/E-mail De' Plaque Inc., Victor, NY
Journal of the ADA
Dental Arts Laboratories Inc, Peoria, IL
Subscribe
Educative material is presented to target a larger audience Professional Product
Review
Dentatus USA Ltd., New York, NY
Dentsply International, York, PA

of implant service receivers, providers and distributers. DENTAL CAREERS AND

JOB LISTINGS
Drake Precision Dental Lab, Charlotte, NC
Essential Dental Systems, South Hackensack, NJ
EVIDENCE BASED
DENTISTRY EURO DENTAL IMPLANT, Houston, TX
PODCASTS
Euro Teknika, Houston, TX
Aim ADA POLICIES & POSITIONS
STANDARDS Florida Dental & Medical Supply, Miami, FL
G & H Dental Arts, Inc., Torrance, CA
This cross sectional study aims to develop a standardized Hartzell & Son, G., Concord, CA

methodology to describe webpage contents in Dental Implamed, Attleboro, MA

(Fig. 1) The Sample of study was derived from the ADA Dental
IMTEC Corp, Ardmore, OK

Implant manufacturers webpages. Links present were ITL Dental, Santa Ana, CA

buying guide, (Implants and Accessories) product category

Keller Laboratories Inc., St. Louis, MO

to be categorized to educational (scientific material) in Lifecore Biomedical, Chaska, MN

accessed on the 7Nobel
th
February
Biocare USA, Inc.,2010
Yorba Linda, CA

comparison with links to information, support services Paragon Implant Company, Encino, CA
Polymedia Inc., Canton, MA
and other web-based material present in. Then a and maintaining the active
PracticeWares Dental Supply, website related to dental
Rancho Cordova, CA

implants. Homepages of San these

Francisco, CAcompanies are listed by
Procera, Yorba Linda, CA
comparison of a sample of homepages for 12 valid Prowest Dental Lab,

and current implant manufacturers was done using this the ADA webpage (fig. 1). Being current means that the
Recigno Laboratories Inc, Willow Grove, PA
Steri-Oss, Yorba Linda, CA

standardized methodology. manufacturer was still distributing the implant system.

Sterngold, Attleboro, MA

Materials and Methods The homepage is defined here Jafar-website

mhtml:file://H:\D\LAYLA\KSA\Research\Implants\D as the first English
research-\implant pop... 27-Dec-11

Definitions
Bicon Dental Implants internet webpage appearing afterPage placing
1 of 2 the simplest
Selection of manufacturers homepages URL address (~.com) and relevant to dental implants.
A valid and current manufacturer means; that the Once placed in the address bar, the URL address
company is consistent in its ownership, still managing could either remain the same, or it could automatically

(Fig. 2)
Monday, December 26th 2011 3:41PM EST CONTACT US | LAB ONLINE STORE
Sample of one of
i s s the comprehensive
Since 1985 Simple. Predictable. Profitable. Search webpages
containing icons
s
HOME OVERVIEW PRODUCTS CASES VIDEOS COURSES CALENDAR MANUALS DOWNLOADS NEWS for the three main
categories (e:
s Bicons unique dental implants and its revolutionary clinicalitechniques have not only passed the test of time, but
Clinically proven since 1985,
i i also educative materials,
e e e
continue to lead implant dentistry. We welcome your joining Bicon clinicians from around the world, so that both you and your patients may also
i: informative
enjoy the many clinical benefits of Bicon implants.
materials, s: service
provisions). Flashes
UPCOMING COURSES
2/1-3 Surgical and Prosthetic
and animations
Principles Course Boston, MA are not active in
e 2/8 Intro Live Surgery Tutorial
1 London, UK this still image nor
2/17 Hands-On Practical Course are embedded lists
Boston, MA
2/21 Treatment Planning Tutorial
apparent
e 2 Lndon, UK

UPCOMING EVENTS
1/26-28 Yankee Dental
LATEST VIDEOS e Congress Boston, MA

s REGISTER for Upcoming Webcast

Webcast Replays
2/23-25 Chicago Midwinter
Meeting Chicago, IL

Introductory Videos 3/1-3 AO Annual Meeting

e Technique Videos e Phoenix, AZ
e Case Study Videos

s i
Information for Patients
Since 1985 dentists have been offering patients
the benefits of the Bicon Dental Implant System.
With Bicon Dental Implants, your dentist has the
ability to provide you with secure implant
restorations often without the need for
additional grafting procedures. The restorations
will look, feel, and function like natural teeth. We invite you to learn more
e
SHORT Implants
THE BICON DESIGN is driven by
simplicity. One of the cornerstones of
that simplicity is the innovation of
Smile Dental
SHORT Implants. Journal
When the Bicon | Volume 6, Issue 4 - 2011| 15 |
system was first introduced in 1985, its
8.0mm length implants were considered
quite shortmost other implants were at least 12-14mm and
 redirect to another URL. If the webpage is not relevant to
implants, it becomes mandatory to choose the implant
product line. Then the subsequent page is considered the
homepage. Some webpages mandate the selection of
the region first. Once selected, the subsequent page is
considered the homepage.
Sample selection
A convenient sample of dental manufacturers
webpages was chosen. The ADA lists 39 companies in
its dental buying guide IMPLANTS AND ACCESSORIES
CATEGORY. The list provided, at the time of research,
contains links to subsequent webpages per each company.
Only 12 companies were valid and current implant
manufacturers and their webpages were accessed, while
the rest provided webpages for companies dealing with
implant related materials and devices.
Icon Definition
An icon is defined here as an active link, where a web
component can be clicked by mouse navigation or enter
controls. The webpages provided clickable icons: in the
form of buttons, images, or texts. The total number of
these icons are counted either if directly seen on the home
page or embedded in drop-down lists or in active flashes.
Once clicked, these icons linked the surfer to other
webpages. The labels used on these icons are put in
parenthesis . The subsequent webpage was categorized
according to the material presented in it (fig. 2). Variations
of content are reported in terms of:
Labels and the sum of Educational and scientific
materials provided
Including SCIENTIFIC ACTIVITIES, MATERIALS,
CAREER DEVELOPMENT, CLINICAL SKILL
DEVELOPMENT, DENTAL TECHNICIAN and PATIENT
GUIDED INFORMATION
Labels and the sum of Information materials provided
Including: INTRODUCTORY, DISTRIBUTION,
CORPORATION, HONORARIES and IMPLANTS had MANUALS, DOWNLOADS and INTERNATIONAL
OVERVIEW INFORMATION
Labels and the sum of Services and support
materials provided
Including PRODUCTS, NETWORK OF USERS,
SUPPORT, SERVICES, COMMUNICATION, and
SIGN-UPS
Target audience
The paper describes the targeted audience besides
conventional users of implant related webpages,
including higher dental specialties, other professions and
other users.
Results
Sample selection
Twelve webpages were accessed from the ADA list of
| 16 | Smile Dental Journal | Volume 6, Issue 4 - 2011
total 39 companies present in its dental buying guide
IMPLANTS AND ACCESSORIES CATEGORY. The list
provided, contains links to subsequent webpages per
each company. These were considered sufficient to
develop a standardized methodology of researching the
contents of home pages.
Seven webpages changed their web content slightly
between two points of search (7th February 2010, 20th
march 2010). Changes mainly were in blog areas
called: highlights, news blog, upcoming courses and
upcoming events blogs. One changed a congress
announcement, added a NEWS icon and updated its
copy right statement. Another announced redistribution
of one of its implants. The next added a LAB icon,
updated the flash presenting current events and changed
language names into flags. Finally, one changed some
icons in its footer quick link bar.
Icon Identification on homepage
Results of materials gained by clicking icons are briefed
in table 1, HOME is an icon that leads to the homepage
itself. This is useful as the header and footer links are fixed
in subsequent webpages and could help redirect the reader
back to the original webpage. Other material include.
Educational and scientific material: labels and
subjects
Scientific Activities:
COURSES and UPCOMING COURSE blogs were
the only icons leading to webpages about courses in two
homepages.
Other activities as Meetings, symposia, scientific days,
forums, congresses were announced and linked to, by
labels NEWS and EVENTS present in homepages as
blog sections or icons.
Recourse Materials
Multiple labels were used, DOCUMENTATION,
ARCHIVES, STUDIES, and LIBRARY. One webpage
DOWNLOADS for 12 languages. One webpage had
recourse materials reached by icons embedded in a
drop-down list called CLINICAL RESOURCES, and
contained ARTICLES, BIBLIOGRAPHY, BROCHURES,
LITERATURE and FAQ icons.
Professional and career Development
Icons leading to relevant developments were labeled:
DENTAL PROFESSIONALS, PROFESSIONAL
EDUCATION, CONTINUING EDUCATION,
COURSES, CALENDAR EDUCATION,
EDUCATION CALENDAR, EDUCATION AND
EVENTS, ONLINE TRAINING, CONGRESS and
SEMINAR TOURS.
One webpage had a very rich CONTINUING
EDUCATION icon. It contained a drop-down list of
icons, labeled by name, for 4 seminars, 3 courses, and 2
residencies.
Clinical Skills Development
Icons used were: VIDEOS, MARGINAL BONE
MAINTENANCE, CASE PRESENTATION, and
IMPLANT ABUTMENT SELECTION GUIDE. One
webpage provided to icons DIGITAL DENTISTRY and
a specific NAME-IMAGING TECHNIQUE. Another
had DIGITAL DENTISTRY and INDIVIDUALIZED
PROSTHETICS. One had country selections in drop-
down lists from CAD CAM and CARE a specific
service for customized prosthetics.
Dental technician guided educative material
Icons used were labeled: LAB, LABORATORIES,
TECHNICAL TIPS and TECHNICAL BULLETINS icons.
Patient guided educative material
Icons used were labeled: PATIENTS, and CONSUMER
SITE. Two webpages had a service, selecting country
and region in a drop-down list, changing the language
for the patients.
Three webpages were rich, providing multiple patient
materials. Icons were listed in sections or in drop-down
lists from a PATIENTS icon; FREQUENTLY ASKED
QUESTIONS FIND A DOCTOR, OR DENTIST, ALL
ABOUT IMPLANTS, TESTIMONIALS, PATIENT
STORIES, PATIENTS GUIDE TO IMPLANTS,
HOW IMPLANTS CHANGE YOUR LIFE, DENTAL
GLOSSARY, PATIENT EDUCATION, GUM DISEASE,
RESTORATIONS, PATIENTS SITE, BEFORE AND company and financial news.
AFTER, and PATIENT VIDEOS.
Information material: labels and subjects
Introductory information
Introductions were in the form of full paragraphs.
This was the only section containing paragraphs.
These paragraphs either described the company, or
their implant system. Some webpages labeled those
paragraphs as WELCOME NOTES.
Distribution information
One homepage had a GLOBAL HOME icon which
lead to a new webpage with a map asking to locate the
region, in which the reader is living.
One homepage used both labels GLOBAL WEBSITES
and WORLD WIDE.
Another used INTl and EUROPE leading to
webpages describing regional offices.
One webpage had local distributors in a drop-down list
from the icon PRODUCTS.
Two webpages announced distributor change for one of
their implants.
Corporation information
Labels expected to be used as synonyms were
COMPANY, CORPORATE, OR CORPORATE
HEADQUARTERS, INCORPORATION, INC and
MANUFACTURER. But some homepages used them as
separate icons, each leading to different material.
One webpage used both MANUFACTURER and
COMPANY, two webpages used both HEAD
QUARTERS and CORPORATE, and one used both
CORPORATE and OUR COMPANY. Each of the
coupled icons, led to a different webpage.
News information
NEWS and EVENTS are another example of icons
which seem to be equal but were used as separate labels:
One homepage used EVENTS icon to lead to a
webpage listing scientific events. The NEWS and
PRESS ROOM blog were about products.
In another homepage, NEWS linked to an e-bulletin
mixing product news, offers, technique resources, and
scientific events. The CALENDAR icon led to a list of
scientific events. An icon SUBSCRIBE TO BULLETIN was
also present that webpage.
The next homepage had NEWS AND EVENTS in one
icon and led to the following: press releases, to sign-in
for an e-newsletter, product news, and scientific events.
Another homepage included labels NEWS which linked
to an announcement page, EVENTS led to a list of
trade shows and courses.
Icon NEWS AND EVENTS in the next homepage, led to
The next homepage, EVENTS icon led scientific
courses, while NEWS led to company news, product
news and tradeshows.
Another homepage had CORPORATION ***-NEWS
linking to corporation events and speaks at multiple forums.
The next homepage had EDUCATION AND EVENTS
linked to scientific news, MEDIA led to both scientific
and corporate news.
The later had a news blog related to product news and
company activities, and MEDIA RELATIONS icon for
referred those seeking news.
The final homepage, had TRADESHOWS, E-NEWS
icons and an EDUCATION CALENDAR were dedicated
to scientific events. Icons PRESS RELEASE and E-NEWS
LINKING led to webpages about product news and
clinical techniques, while its HIGHLIGHTS BLOG was
dedicated to product news and scientific events. Two
webpages had no icons termed NEWS or EVENTS
Honoraries
One homepage offered a research prize.
Smile Dental Journal | Volume 6, Issue 4 - 2011| 17 |
 Information Services and Support Educational and Scientific
Introductory Information Products Activities
Introductory Paragraphs 6 Products 9 Upcoming Courses Blog 1
Welcome Notes 2 On-Line Stores or E-Shop 6 Courses 1
About Us 2 My Cart 1 Materials
General Information 1 My Order 1 Documentation 1
Overview 2 My Account 1 Manuals 1
Prefaces, Who Are We?, What Is ?. 0 Consumer Site 1 International Downloads 1
Distribution Information Great Offers 1 Archives 1
Regional Offices Store 1 Studies 1
Global Home 2 Other Equipment 1 Library 1
Product Catalogs, Online, PDF,
Home 7 Ordered to Mail or Email Address, 0 Brochures 1
Restricted (Registering or Subscribing)
Global Websites 1 Finding A Network Of Local Users Bibliography 1
World Wide 2 Locate a Doctor or Find a Dentist 2 Literature 1
Intl 1 Laboratories 1 FAQ 1
Europe 1 Support Articles 1
Distributors 2 Products and Services 1 Downloads 1
Costumers Support, and Costumers
Global Network, Distributors 1 2 Clinical Resources 1
Services
Representatives, Trade Links, Regional Presentation Briefings, Multimedia, Publi-
0 Technical Help and Technical Service 2 0
Homepages, Put on a Map cations, Abstracts, Case Reports, Books
Corporation Information Engineering Services 1 Professional and Career Development
Manufacturer 1 Advisory Board 1 Dental Professionals 2
Company and Our Company 8 Return Policy 1 Calendar 1
Head Quarters 1 Interaction Courses 1
Corporate 3 Comment and Make an Inquiry 2 Education 3
Name- Inc. 1 Help 1 Professional Education 1
Company Logos- Sentence 4 Contact 5 Continuing Education 1
Presidents Message 1 Contact Us, 5 Education Calendar 1
Executive Profile 1 Email Us 1 Education and Events 1
Company News 1 Search Boxes 7 Congress 1
Jobs and/or Careers 5 Search 1 Seminar Tours 1
Investors and/or Investor Relation 2 Sitemap 3 Online Training 1
Carriers Regional Sales Managers 1 Signups Name- Residency 2
Company Activities Platinum Name- Course 3
Trade Shows and Appearances 3 Login Name- Seminar 4
Events 3 Extranet Login Clinical Skill Development:
News 4 Signup for an E-Bulletin 1 Videos 2
News and Events 2 E-News Letter 1 Manuals 1
E-News 1 Signup Forms for E-News 2 Cases 1
Sign-In for an E-News Letter 1 Pod Casts 1 Case Presentation
Subscribe to Bulletin 1 Web Casts 1 Digital Dentistry 2
Corporation Name-News 1 Syndications as RSS 0 Name of Imaging Technique 2
Education and Events 1 Individualized Prosthetics 1
Media 1 Implant Abutment Selection Guide 1
Highlights Blog 1 CAD CAM and CARE 1
Press Room Blog 1 On Marginal Bone Maintenance 1
News Blog 1 Dental Technician Guided Information
Media Relations 1 Laboratories 2

| 18 | Smile Dental Journal | Volume 6, Issue 4 - 2011

 Information Services and Support Educational and Scientific
Introductory Information Products Activities
Press Release 1 Technical Tips 1
Company History, Corporation Struc-
0 Technical Bulletins 1
ture, Staff Info.
Legal and Webpage Issues Lab 1
Site Requirements 1 Patient Guided Information
Copyright Declarations 10 Patients Resource 1
Legal Notices/ Terms/ Information 4 Patients 9
Privacy Policy/ Statement 7 Patients Site 1
Disclaimer 1 Patient Education 1
Trade Marks 1 Consumer Site 1
Conditions/Terms of Use 3 Frequently Asked Questions 1
Imprint 1 Find a Doctor, or Dentist 1
Honoraries All About Implants 1
Research Prize 1 Patients Guide to Implants 1
Surveys 3 Patient Videos 1
Honors, Voted, Prizes (Products or
Company) Quality Assurance Approv- 0 Before and After 1
als, Polls
Implants Overviews Dental Glossary 1
Implant History 1 Restorations 1
Image of the Abutment/ Implant 3 Single Tooth Restoration 1
Implant Fixtures 1 Multiple Teeth Restoration 1
Healing Abutments 1 Over Dentures 1
Implants and Abutments 1 Partial Dentures 1
Innovation, Advancements, Latest,
0 Gum Disease 1
What's Hot, New!
Past Products, Deceased Lines, Manu-
0 Testimonials 2
facturing Process
Compatibility with Other Implant
0 Patient Stories 1
Systems
How Implants Change Your Life 1

(Table 1) Icons and content numbers are reported, for those included in dental implant manufacturers home page.
Note: ( ) designate icons labels, (/ )separates possible synonyms, INTL = international, FAQ = frequently asked questions (labels
are quoted exactly as they appear in the webpage), and finally, name- ****** indicates that the label uses trade names for the
incorporation or a product line in the label. These are not reported here to preserve the identity of webpage. Repeated icon names in
different categories indicate that these icons lead to different webpages addressing each separately, although having the same label.

Surveys products using the label PRODUCTS in the form of

One homepage provided 3 icons to different surveys. icons, flashes, and videos.

Implants overviews Three homepages studied were redirected to implant

Some of this information was present in subsequent
webpages from NEWS and EVENTS icons, as
advancements. More information will be displayed in the
PRODUCTS icon explained later. Other information
were contained in icons IMPLANT FIXTURES and
HEALING ABUTMENTS. One webpage provided an
icon indicating the compatibility of their abutment with
other implant systems.
Services and support material: labels and subjects.
Products: homepages provided information about
webpages, as the first simple (~.com) webpage had no
information on implants but featured other products.
Once reaching the implant related webpage, now
considered the homepage, one of them had a drop-
down list from PRODUCTS icon listing 4 implants and
3 implant related materials. The other two listed the
implants and related products on the webpage itself.
Icon PRODUCTS, is another example of how a
label is variably used and leads to different webpage
materials. One homepage used the label PRODUCTS

Smile Dental Journal | Volume 6, Issue 4 - 2011| 19 |

 that led to other products which were not implants or
implant related. Another homepage had a drop-down
list embedded in the PRODUCTS icon, hiding further
icons for 8 implant products, 5 prosthetic products, and
11 surgical regenerative materials, related to implant
therapy. One homepage had PRODUCTS icon leading
to 2 implant lines and 5 implant related material.
The next description of the label PRODUCTS is more
complex as more material lie one click away, even not
related to implant products.
One homepage used PRODUCTS icon to lead to
a webpage containing introductory paragraphs and
further icons for implants, implant related materials
and software. It also had icons labeled MANUALS,
PROCEDURES, PRODUCT CATALOGUE and HOW
TO ORDER.
A second homepage linked PRODUCTS to a
webpage containing images and an overview of one
implant, more icons for PRODUCT INFORMATION,
CASE STUDIES, IMPLANTS, ABUTMENTS and Sitemaps helped online interaction with the web
KITS, INSTRUMENTATION, GRAFT MATERIAL, content of subsequent pages.
TRANSITIONAL IMPLANTS, EDUCATIONAL
MATERIALS, REFERENCES, FAQ and DOWNLOAD Signups
PDF CATALOGUE.
A third homepage linked PRODUCTS to a webpage
containing an overview of one implant then icons
FOR IMPLANTS, REGENERATIVE, SURGICAL,
RESTORATIVE, SHOPPING CART, CATALOGUE, Sum of links per Category
SURGICAL MANUAL and CLINICAL OVERVIEW.
A fourth webpage homepage linked PRODUCTS to a
webpage containing a list of further icons for IMPLANT
PRODUCTS and 6 products not related to dental
implants. It also had the contact address.
The fifth homepage linked PRODUCTS to a webpage
containing introductory paragraphs, 5 implants
icons, and icons labeled NEW PRODUCTS and
INSTRUMENTS COMMON TO IMPLANTS.
The sixth homepage linked PRODUCTS to a
webpage containing introductory paragraphs, 7
icons for implants and implant related materials, and
icons labeled IMPLANT TRAINING, CONCEPTS,
SOLUTIONS FOR INDICATION, CASES AND
SOLUTIONS PRODUCTS, SCIENTIFIC EVIDENCE
INDIVIDUALIZED PROSTHETICS, DIGITAL
DENTISTRY, EDUCATION AND EVENTS, SCIENCE
AND ENOVATION CLINICAL MANUAL, SHOP
ONLINE PRODUCT QUICK LINKS and DIGITAL
PRECISION ICONS.
The final webpage homepage linked PRODUCTS to a
webpage containing an introductory paragraph, a drop
| 20 | Smile Dental Journal | Volume 6, Issue 4 - 2011
down-list of countries, to locate choose local markets
and one icon leading to CAD CAM
Finding a network of local users
Three homepages provided this service by icons labeled
as LOCATE A DOCTOR icon in a drop-down list from
PATIENTS RESOURCES, FIND A DENTIST in the drop
down-list from PATIENTS, and LABORATORIES in the
drop down-list from PROGRAMS
Support
Labels used by icons leading to this material were
PRODUCTS AND SERVICES, COSTUMERS SUPPORT,
COSTUMERS SERVICES, TECHNICAL HELP,
TECHNICAL SERVICE, ENGINEERING SERVICES icon for
designers, ADVISORY BOARD and a RETURN POLICY
Interaction
Homepages provided some interaction with the
consumers by asking for Feedback and interaction in
icons labeled COMMENT and MAKE AN INQUIRY,
HELP, and ADVISED CONTACTS icons. Search boxes
Membership applications were present by icons, as
well as SIGNUP FOR AN E-BULLETIN and E-NEWS
LETTER. One homepage had POD CASTS and
multiple WEB CASTS to sign up for.
Webpages obtained in this sample, contained a sum of
93 informative icons, 64 services and support icons and
85 educative icons, after excluding the icons related to
legal and copyright notes, not relevant to the study.
Three webpages could be described as comprehensive,
including icons leading to all categories under study.
They linked to 78, 57 and 42 different webpages
respectively. One webpage (117 icon links) lacked icons
for the essential educational category on its homepage.
Interested groups which may find relevant material
Patients, general dental practitioners and technicians
could be considered conventional users of these
webpages. They would seem to benefit the most as the
majority of the icons, relevant to the three categories
under study, were directed to this group.
However, some icons and content of the homepages
were found to meet the interest of: Periodontists,
Surgeons, Prosthodontists, CAD CAM users, Esthetic
dentists, and Radiologist. These included a few, highly
specific, line of products or highly specialized techniques.
Other dental professions as researchers, reviewers of
systematic reviews, evidence seekers, academicians and
students could find a share of the interest, but indirectly; as
there are no dedicated icons addressing their specific needs.
Unusual interests were met, but with a few number
of icons, for the general public, dental administrative
workers, treatment seekers or tourists, investors, the
press, internet link seekers, internet bloggers, web page
developers, designers and inventors.
Discussion
The methodology developed in this study
This study is the first within the knowledge of the
author- which studies the dental implant manufacturers
webpages from this angle. The necessity for categorizing
materials linked from the webpages and presenting
this work comes from a previous study where there
was a need to scan all available lists of dental implant
manufacturers to compare implantabutment interfaces
and its mechanics. The researchers were faced by the
huge variability of webpages and the confusion in the
labels of icons, leading to different materials each time.
Of a total of 150 webpages, the gathered experience
was sufficient to develop the methodology for this study,
and be presented to the reader who will face such
confusion when doing any search for multiple implant
systems for any reason.
Educative material was the focus of this study as
educating possible users increase their confidence and
provide them with sufficient evidence as required for high
quality treatments. This methodology can be repeated to
study any dental or medical product or service providers
webpages to describe and develop recommendations for
their content.
The role of implant manufacturers webpages
Implant manufacturers have developed their webpages
to become a rich niche. Attracting the users or potential
users to longer sessions of webpage viewing and surfing
would indirectly help making the implant system familiar
to visual and comprehension senses. These methods
include:
Developing more interactions by clickable and
navigation-activated icons, makes it less boring.
Additions of whole page flashes are still limited in the
sample of study, but partial flashes make the webpage
appear lively.
The addition of larger numbers of icons embedded
in drop-down lists and pop-out windows increase the
chance of including a term, thatmeets an interest or need.
The efficiency of searching sessions in targeting needed
information is reached as more searches are done,
more subsequent webpages are explored and refined
and using correct tools as search boxes and site maps.
It is guided by how the learner is motivated.9 The use
of a search box, for even the experienced, is the next
immediate option, if the relevant icon of interest is not
perceived directly from the homepage. So having such
tool is essential. Searches usually include an average of
two terms. If well studied, the webpage developers of
the site would annually accumulate these search terms
placed in their search boxes and add or rename their
homepage icons to reflect those terms, most in demand.
Customizing the contents, either to regions, languages,
individual accounts, logins, memberships and icons
labeled my-*****, may increase pertinence. Finally,
including multiple links to a single target increases the
chance of clicking an icon.
The previous were general methods used by most
webpages of the study. Three webpages were considered
comprehensive as they used more methods to attract
the surfer. They used multiple icon formats, leading to a
single page as a way of overcoming variability present
in internet experience of surfers. Attracting casual users
by images, flashes, and videos seems logic and was
used. Also including quick link bars in the header,
footer, and the side, would increase the chance of hitting
relevant information. Repeating those quick link bars
in subsequent pages makes the surfer oriented. Having
a site map has also this effect. Assigning sections in
the webpage, for each of the conventional users, and
concentrating their relevant links in that area, are even
more methods used.
Are the implant manufacturers webpages informative?
Looking at the homepage only, the direct answer to this,
is no!. There is a very limited number of paragraphs that
could add to the information of the surfer. These are
limited to welcome notes, very short sentences displaying
the companys logo, or introductory paragraphs either to
the company or implant system used.
But when clicking icons for educative, informative, and
supportive or service providing materials, opening each
single webpage which is present one-click away could
answer some of that need. The action of webpages acting
as good directories should also be balanced with the
limitation that most users have, which is that they click no
more than only two pages away. So it is essential to have
the actual information, one or two-clicks away, at best.
Examples of this suggested confusion were for the
icons NEWS, EVENTS, PRESS RELEASE and
PRODUCTS. The subsequent pages were variable.
Some did not include enough information, but only
adding a new list of icons to be searched. Others include
icons which may seem to be essential, but hidden from
the homepage. If taking the classification of categories
used in this study as a reference, some information in the
subsequent pages was under un-expected icons labels,
mixing the needs, and adding to the confusion of surfer.
Opening the subsequent page was essential for another
reason. Many of the terms used in the labels of icons
Smile Dental Journal | Volume 6, Issue 4 - 2011| 21 |
 were not clear, and only after opening the next page,
was the meaning explored. Many icon labels, which
seemed to be synonyms, were not used as such. So there
is a need for a standardized labeling method.
Are the implant manufacturers webpages educative?
To answer this critical question, levels of education are
separated, in the following discussion.
Patients education material
Retention of dental information is enhanced by the net10
and consumers look for health care information online.11
using the net by patients was to change dentists,
travel, discuss treatment with their dentists, ask for
more explanations, which may be considered by some
clinicians to be a burden on valuable clinical time. But
this had, in some occasions, led to patients demanding
inappropriate care or more complex treatment, if the
information is not validated.12
Educating this group is essential, by providing an
abundance of scientifically valid material in reliable
resources, rather than the subjective material, limited
in experience and disseminated in chat rooms and
unspecialized forums.
Implant webpages provide material for patients in many
forms. Introductory into implants, implant treatment
options, what is expected from the treatment and
brochures and leaflets. Customization of the material
is done in a few webpages, where language is selected
by the patient. Services follow, leading patients to
doctors who use their system, testimonials and stories
of who had a chance to get them done, BEFORE AND
AFTER images, and PATIENT VIDEOS. All of these are
minimally educative-informative icons. Better educative
resources are expected in labeled icons: FREQUENTLY
ASKED QUESTIONS DENTAL GLOSSARY, PATIENT and may lack comparative clinical studies leading to
EDUCATION, GUM DISEASE, RESTORATIONS, conclusions from the experience.
PATIENTS SITE, and these are present as icons in
more comprehensive webpages. These were present in a
limited number of webpages.
Undergraduate dental surgeons, hygienists,
assistants, and technician students
For this group, internet is now promoted to be an
education recourse and assistant to conventional methods.
Students had responded by accepting it, retaining
more information by it, and considering it an essential
adjunctive to conventional methods.13,14 Providing the
material through a central location for e-resources, and
be connected to wider geographical distributions as by
podcasts, significantly increased their interest.15
Student preferences were then announced by many
studies about what should the material look like on the
net, to consider it educative. Material is preferred to be
| 22 | Smile Dental Journal | Volume 6, Issue 4 - 2011
accessed off-campus,16 standardized in terms of labels
and format, outlined in an e-syllabus,17 and visually
perceived. Illustration methods are preferred in the forms
of SLIDE GALLERIES, SLIDE SERIES and streaming
videos. High quality images or videos were preferred if
supported by the DSL connection, contained sound and
text subtitles, short, and embedded in the text.18 Online
quizzes produced variable response. Such inclusions
produced greater interaction, motivation and knowledge
retention.19-21
As previous experience with online material is confounding
factor to this group,22 material provided should have simple
interactions to reach needed information.
The introduction of dental implants into the curriculum
of these undergraduate courses has been reliant on
text books and lecture notes. The role of dental implant
webpages in providing educative material to these
groups is anticipated but not met directly as the student
is faced with no icons relevant to their needs. They could
access some of the patient materials, but would not
be able to comprehend all the professional terms and
specialized techniques for technician and professional
sections. Simple terminologies, more illustrated
techniques and well labeled icons could be areas of
further advancement towards being more educative.
Schools that adopt teaching comprehensive treatment
planning and team approach therapies, in final years,
are faced with bit more difficulty. The reliance on
experienced educators increases, to guide the students
through their pile of accumulating study materials. The
level of depth varies, in these approaches, according
to the dental school plans. The educators may face the
problem of introducing the current systems, using any of
the material provided by the implant webpage as they
are insufficiently directed from the homepage icons,
Dental education
Professional development materials are present in
many dental implant manufacturer webpages. Different
levels of specialty are also present but the problem is
faced where many of the intended material is present
in subsequent webpages, which may not be clear and
explored by the homepage icons. If the item is not
present, then facilities as site maps and search boxes
are the next choice. Some users often go straight to the
search feature on a site when it is present even before
searching the icons of the homepage.23
This richness meets the definitions of a dental portal but also
the definition of power searching; process of finding good
quality information from the web as quickly and as easily
as possible.24 But scientific validity and level of evidence
produced in these webpages warrant more research.
A side missing from these webpages is the retrieval
of implants in cases of failure.25 Only one webpage
provided a return policy. Presence of such material
or through communication with a suggested list of
experienced clinicians, can aid in reducing the more
stressful aspects of implant dentistry.
Limitations of the study
1. It is a study of only the first homepage as it is
considered here as the first window which should
guide the browser to their specific knowledge needs.
2. The use of synonyms could not be concluded. There
are no references for the number and use synonyms
that may indicate a single subject. These are
collectively added to the lists but those that were felt to
be different were separated.
3. This research should mandatory be repeated, using
this methodology, but studying the webpages one or
two pages away from all homepage icons. This would
give a better insight to the answer of this studys
question. e.g products may lead to a catalogue,
download material can lead to scientific literature
or catalogues. So even the lack of the icons leading
to some category materials, may not necessarily be
inferring their lack from the whole page.
4. The scientific validity of educative material and the
level of evidence provided by them have not been
verified. The material could be highly reliable if
produced from systematic reviews and randomized
clinical trials, or less reliable if concluded from case
studies, non-controlled short term studies. Better
scientific referencing of information is required.
5. It is recommended for quality assurance bodies to
mark presented materials according to the level of
evidence.
6. There is lack in educative materials for students
although they could share the regular interest on
sections of FAQ or introduction to but labeling a
section for students would seem reasonable.
Conclusions
Richness in the webpages provided by dental implant
manufacturers meets the need for many. However,
scientific validity and level of evidence produced in these
webpages warrant more research. Better referencing
of educative material is required. Student educative
materials are lacking.
Acknowledgement
The author would like to acknowledge the Deanship of
Research in Jordan University of Science and technology
for funding multiple Dental Implant researches, from
which the experience had accumulated to perform this
study. And would thank colleagues at the faculty of
Dentistry for in depth discussions and cooperation.
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