Awareness and attitudes toward digital technologies in orthodontics among dental students in Turkey: a cross-sectional study

Abstract

Background

Digital technologies have become increasingly integrated into orthodontic practice for diagnosis, treatment planning, and appliance manufacturing. This study aimed to assess undergraduate dental students’ awareness and attitudes toward the use of digital technologies in orthodontics and to explore the potential influence of academic year and intended specialization on these perceptions.

Methods

This cross-sectional study was conducted among third-, fourth-, and fifth-year undergraduate students at Istanbul Aydin University, Faculty of Dentistry, during the 2023–2024 academic year. A structured online questionnaire was developed to evaluate students’ awareness and attitudes regarding the use of digital technologies in orthodontics. The questionnaire comprised three sections: demographic information, binary (yes/no) questions assessing awareness, and seven attitude statements evaluated on a 5-point Likert scale. Group comparisons were performed using the Pearson Chi-square test or the Fisher–Freeman–Halton exact test for categorical variables, and the Kruskal–Wallis test for ordinal data. Explanatory factor analysis using principal component analysis with Varimax rotation was applied to assess the construct validity of the attitude scale. Statistical significance was set at p < 0.05.

Results

A total of 278 dental students participated in the study, including 179 females (64.4%) and 99 males (35.6%), with representation from the third (37.4%), fourth (34.9%), and fifth (27.7%) academic years. The most commonly recognized digital orthodontic applications were the fabrication of clear aligners using three-dimensional (3D) printing (91.7%) and the use of intraoral scanners for digital impressions (87.1%). Awareness of cone-beam computed tomography (CBCT) increased significantly with academic year (third: 36.5%, fifth: 71.4%, p < 0.05), while awareness of digital treatment planning tools declined (third: 43.3%, fifth: 24.7%, p = 0.025). Similarly, knowledge of 3D-printed appliances (third: 43.3%, fourth: 15.5%, p < 0.05) and in-office aligner production (third: 36.5%, fourth: 67%, p < 0.05) varied significantly across years. Attitudinal responses indicated generally positive views toward the integration of digital technologies into orthodontic practice and education. Significant differences were also observed in selected attitude items according to academic year and intended specialization (p < 0.05).

Conclusion

This study demonstrated that dental students were more familiar with commonly used technologies such as intraoral scanners and 3D-printed clear aligners, whereas their awareness of other digital applications in orthodontics remained limited. Overall, attitudes toward digital integration were positive across all academic years. Interestingly, despite having more clinical experience, final-year students reported lower awareness in certain areas, underscoring the importance of complementing early theoretical education with consistent and structured clinical exposure in later years.

Clinical trial number

Not applicable.

Background

Globally, dental education follows an integrated model comprising theoretical instruction, simulation-based preclinical training and clinical experience involving direct patient care [1]. Although program duration varies by country, dental education typically spans four to six years, with basic science and preclinical simulation in the early years and clinical practice in later stages [2]. As a specialty, orthodontics is included in undergraduate curricula to provide foundational knowledge and skills [3]. Since the American Dental Education Association (ADEA) introduced a structured orthodontic curriculum in 1993—covering “Growth and Development,” “Preclinical Orthodontics,” and “Clinical Experience”—technological and scientific advancements have prompted ongoing updates to reflect modern practice [4].

Digital dentistry has become an integral part of contemporary dental practice and is now widely utilized in the field of orthodontics for diagnosis, treatment planning, and therapeutic procedures. During the data acquisition phase, intraoral scanners and CBCT systems facilitate the collection of precise digital records. In the diagnostic and treatment planning phase, specialized software enables comprehensive analysis and virtual simulations. During the treatment phase, digital systems are used for the fabrication of clear aligners via computer-aided design and computer-aided manufacturing (CAD/CAM) technology, customized arch wires and bracket systems, and the production of orthodontic appliances such as splints for orthognathic surgery and in-office aligners through 3D printing techniques [5]. With the advancement of artificial intelligence, there has been a notable acceleration in the development and integration of digital technologies into orthodontic workflows, including the use of digital planning software and 3D-based tools for diagnosis and treatment [6]. Additionally, teledentistry applications are increasingly integrated into patient follow-up and consultation services, enhancing accessibility and efficiency in orthodontic care [7]. Although digital technologies offer significant advantages, limitations in users’ knowledge and technical proficiency may hinder their integration into routine dental practice, affecting their effective implementation. Therefore, it has become essential to incorporate digital workflows and technologies into dental education programs to ensure that future practitioners are adequately prepared for contemporary clinical demands [8].

Dental students should be equipped to manage digital data effectively when collaborating with dentists, physicians, and dental technicians. This requires a comprehensive understanding of the strengths and limitations of conventional and digital workflows [9]. Consequently, the integration of digital dentistry into undergraduate curricula is increasingly recognized as a fundamental element of contemporary dental education [10]. Therefore, contemporary dental education should not only focus on foundational practices such as diagnosis and treatment planning, but also foster students’ ability to critically appraise scientific evidence, comprehend innovative digital applications and effectively integrate digital health technologies into professional practice. In this context, academic institutions carry the responsibility of preparing students to be technologically competent, innovation-driven, practice-oriented professionals who are adaptable to evolving digital advancements [11, 12].

It has been stated in the literature that students have a positive attitude and increased motivation towards the integration of digital dentistry into general preclinical education [13,14,15]. Students’ intention to use digital technology in future practice is associated with factors such as knowledge, positive attitudes, social norms, and perceived control [14]. Although the increasing role of digital technologies in general dentistry and preclinical education has been addressed in the literature, studies examining student attitudes specific to the field of orthodontics are limited. However, the rapid integration of digital applications into orthodontic diagnosis and treatment processes makes the evaluation of awareness and perspectives in this field critical for both updating educational policies and guiding future clinical practices. In addition, examining the possible relationships between students’ awareness and attitudes towards digital orthodontic applications and the areas of specialization they plan to choose in the future can make significant contributions to the digitalization process of dentistry education.

Currently, dental education is in a transitional phase, during which questions regarding the timing, extent and content of the integration of digital technology into curricula remain unresolved [9]. Consequently, student feedback on this matter is of great importance. The literature widely emphasizes that surveys conducted among dental students are essential for assessing and enhancing clinical experiences, curriculum environments and pedagogical approaches [16, 17]. In this context, the present study aimed to assess dental students’ awareness and attitudes concerning the use of digital technologies in orthodontics. Furthermore, the influence of students’ academic year and postgraduate specialty preferences on their awareness and attitudes was examined. This study seeks to identify potential gaps within the digitalization process of dental education and to contribute to the enhancement of practical educational content based on students’ perspectives and expectations.

Methods

A structured, questionnaire-based online survey was designed to evaluate undergraduate dental students’ awareness and attitudes towards the use of digital technologies in orthodontics. The survey questions can be found in Supplementary File 1. The questionnaire was developed based on previously studies in the literature [14, 18,19,20,21,22,23,24,25,26]. Ten undergraduate dental students participated in a pilot test of the questionnaire. Following the feedback received from the pilot testing, necessary modifications were made, and the final version of the questionnaire was established. A summary of the item development process, including original and modified items with corresponding references, is provided in Supplementary File 2.

The questionnaire comprised 20 structured questions, divided into three content-specific sections. The first section collected demographic information, including participants’ gender, age, and academic year. In addition, participants were asked whether they intended to pursue a postgraduate specialization, and if so, which specialty they were considering. The second section assessed students’ awareness of digital orthodontic technologies using yes/no questions. The third section evaluated students’ attitudes and perspectives using 5-point Likert scale items, with response options including “strongly disagree” [1], “disagree” [2], “neutral” [3], “agree” [4], and “strongly agree” [5]. Prior to participation, students were informed about the purpose of the study, the voluntary nature of participation, and the confidentiality of their responses.

The study encompassed third-, fourth-, and fifth-year undergraduate dental students (n = 278) from the Faculty of Dentistry at Istanbul Aydin University during the 2023–2024 academic year. The inclusion criteria stipulated that participants must be enrolled in their third, fourth, or fifth year of undergraduate dental education and must have voluntarily agreed to participate. First- and second-year students were excluded, as they had not yet undertaken the orthodontics course. The total number of eligible students was 319. Based on a 95% confidence level and a 5% margin of error, the minimum required sample size was calculated as approximately 176 students using an online sample size calculator (https://www.calculator.net/sample-size-calculator.html). The final response rate was 87.1%.The questionnaire, created using Google Surveys (Google Inc., USA), was distributed to students via a digital link. Participation was entirely voluntary, and informed consent was obtained from all participants at the beginning of the survey. The study was conducted at Istanbul Aydin University Faculty of Dentistry, Department of Orthodontics, and approved by Istanbul Aydin University Non-Interventional Clinical Research Ethics Committee with decision number 54/2024. This study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement guidelines.

Statistical analyses

Descriptive statistics were used to summarize the demographic characteristics of the participants. Frequencies and percentages (n, %) were presented for categorical variables such as gender, academic year, and postgraduate specialization preferences, while medians with minimum and maximum values were reported for continuous variables such as age. The normality of the data was assessed using the Shapiro–Wilk test, as group sample sizes were less than 50. Since the data did not follow a normal distribution, numerical variables were summarized using medians and interquartile ranges (IQR). Comparisons of ordinal variables across more than two independent groups were conducted using the Kruskal–Wallis test. Associations between categorical variables (e.g., academic year and binary responses) were analyzed using the Pearson Chi-square test, provided that the assumption of expected cell counts was met. When this assumption was violated, the Fisher–Freeman–Halton exact test was applied. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 25 (IBM Corp., Armonk, NY). A p-value < 0.05 was considered statistically significant.

Scale validation

Explanatory factor analysis (EFA) was conducted to evaluate the construct validity of the seven-item attitude scale [7]. The suitability of the dataset for factor analysis was confirmed by the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy (0.728) and a significant result from Bartlett’s Test of Sphericity (χ² = 300.240, df = 21, p < 0.001), indicating that the correlation matrix was appropriate for factor extraction. Principal Component Analysis with Varimax rotation was applied. Based on the eigenvalue criterion (>1), two factors were extracted, which together accounted for approximately 52.3% of the total variance. All items demonstrated acceptable communalities (>0.40), and no items were excluded from the analysis. Following the EFA, a confirmatory factor analysis (CFA) was conducted to test the structural validity of the seven-item attitude scale. The results supported a two-factor model with acceptable fit indices: CFI = 0.968, TLI = 0.948, NFI = 0.927, GFI = 0.986, RMSEA (90% CI) = 0.050 (0.000–0.085), and SRMR = 0.059. These findings provide evidence for the construct validity of the instrument. Reliability analysis showed a Cronbach’s alpha coefficient of 0.628, suggesting acceptable internal consistency [27].

Results

A total of 278 students from three academic years participated in the study. Of the participants, 179 (64.4%) identified as female and 99 (35.6%) as male. The participants were distributed across the 3rd (n = 104, 37.4%), 4th (n = 97, 34.9%), and 5th (n = 77, 27.7%) years of study. The median age of the participants was 23 years, ranging from 20 to 34 years in the 3rd year, 21 to 30 years in the 4th year, and 21 to 30 years in the 5th year (see Table 1 for details).

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As presented in Table 2, 5.2% of students reported no intention to pursue specialization. Orthodontics (24.1%) and oral and maxillofacial surgery (19.8%) were the most preferred fields. Orthodontics was favored predominantly by females (67.2%), while oral and maxillofacial surgery was more commonly chosen by males (56.4%). Pediatric dentistry (6.5%) and restorative disciplines such as periodontology, prosthodontics, and restorative dentistry were selected mostly by female students. Endodontics showed an equal gender distribution.

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As shown in Table 3, the most widely recognized digital orthodontic application among students was the production of clear aligners using 3D printing, reported by 91.7% of participants. Additionally, 87.1% indicated awareness of the use of intraoral scanners for obtaining digital impressions in orthodontic practice, while 55% were aware that clear aligners can also be produced in-office through digital technologies. Awareness of the use of CBCT for three-dimensional imaging was reported by 51.8% of students.

In contrast, fewer students reported awareness of other applications: 33.8% were familiar with the use of digital software for diagnostic and virtual treatment planning purposes, and 34.5% were aware of teledentistry for orthodontic consultation and patient follow-up. Awareness of digitally customized arch wires and bracket systems was noted by 30.2% of students, while 29.1% reported knowledge of the production of orthognathic surgery splints, expansion appliances, and other personalized devices using 3D printing technology.

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Statistically significant differences were observed across academic years in students’ awareness of specific digital orthodontic applications (Table 4). Awareness that CBCT is used for three-dimensional imaging increased significantly with academic seniority (p < 0.05, Cramer’s V = 0.3), reaching 71.4% among fifth-year students. Similarly, awareness of in-office clear aligner production using digital technologies differed significantly by year (p < 0.05, Cramer’s V = 0.3), with higher recognition among fourth- and fifth-year students. Awareness of 3D printing technology in the fabrication of orthodontic appliances also varied significantly across years (p < 0.05, Cramer’s V = 0.26), with third-year students reporting the highest rate. Additionally, awareness of digital software for diagnostic and virtual treatment planning purposes showed a significant difference by academic year (p < 0.05, Cramer’s V = 0.16), again with the highest awareness among third-year students.

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In contrast, there were no statistically significant differences between academic years in the proportions of students who reported awareness of the use of intraoral scanners for obtaining digital impressions, the production of clear aligners using 3D printing technology, the fabrication of customized arch wires and bracket systems through digital orthodontic workflows, and the use of teledentistry in orthodontic consultation and patient follow-up (p > 0.05)(Table 4).

When evaluated according to students’ intended specialization preferences, no statistically significant differences were found between the groups in responses to most questions related to digital technologies (Table 5). According to students’ specialization preferences, no statistically significant differences were observed for most questions on digital technologies (Q6–Q11, Q13; p > 0.05), except for Q12 regarding in-office aligner production (p < 0.05, Cramer’s V = 0.34). The highest proportions of affirmative responses to this item were recorded in the group with no intention to specialize (71.4%) and in those considering periodontology (71.4%), while the rate was lower among those intending to specialize in orthodontics (44.8%).

As shown in Table 3, student responses to the attitude items regarding digital technologies in orthodontics demonstrated variation across the statements. While 37.4% of students agreed that ongoing digital advancements may reduce the need for traditional orthodontic interventions in the future, 10.8% strongly agreed. Only a small proportion of students expressed concern about digitalization, with 6.8% agreeing and 4% strongly agreeing with the statement. In contrast, 64.4% either disagreed or strongly disagreed. A more positive attitude was reflected in responses related to the integration of digital technologies into orthodontics. A total of 41% of students agreed and 24.5% strongly agreed that they were enthusiastic about this integration. Additionally, 24.5% of students agreed and 21.9% strongly agreed that digital developments had increased their interest in pursuing orthodontics as a specialty. Regarding the perceived benefits for patients and practitioners, 33.1% and 47.1% respectively agreed. In terms of educational expectations, 28.1% of students agreed and 40.3% strongly agreed that undergraduate dental training should include digital orthodontic tools and technologies. Similarly, 20.1% of students agreed and 31.3% strongly agreed that postgraduate education should offer comprehensive training in the application of digital technologies in orthodontic practice.

As shown in Table 4, student attitudes toward digital orthodontic technologies were largely consistent across academic years. Significant differences emerged only for two items: fifth-year students more strongly agreed that digital advancements may reduce the need for traditional interventions, and both third- and fifth-year students showed greater support for including digital training in postgraduate education (p < 0.05).

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A similar trend was found across specialization preferences (Table 6). Although most attitude items showed no significant differences, two items varied by group. Students aiming for orthodontics, pediatric dentistry, and prosthodontics reported higher agreement that digital advancements increased their interest in the specialty (p < 0.05, ε² = 0.058). Additionally, support for postgraduate training in digital orthodontics was greater among those pursuing endodontics and restorative dentistry (p < 0.05, ε² = 0.037), indicating small to moderate effect sizes for both items.

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Discussion

Digital adoption, as in all fields of dentistry, has become a clinical reality in orthodontics [28]. As tools like intraoral scanners, digital planning software, and 3D-printed aligners are increasingly used in routine workflows, dental professionals must adapt to this shift. Undergraduate orthodontic education varies across the world [3, 29, 30]. In Turkey, the undergraduate dental curriculum is organized by the Council of Dental Deans – Education and Research Subcommittee (CDD-ERS) and guided by the National Core Education Program for Dentistry (DÜÇEP-2021), which emphasizes that graduates should be competent in diagnosing orthodontic problems, assessing treatment needs, and referring patients appropriately to specialists when necessary [31, 32]. In this context, assessing dental students’ awareness and attitudes toward digital orthodontics provides valuable insight into current educational practices and supports curriculum planning in line with ongoing digital advancements in dentistry.

CBCT is widely used in orthodontics to obtain 3D images for diagnosis, treatment planning, and assessing outcomes [33]. It has been reported in the literature that CBCT imaging has been incorporated into undergraduate curricula in dental schools in the United States, the United Kingdom, and Australia; however, a need for more comprehensive training at the undergraduate level has also been emphasized [34]. In a study conducted by Kamburoglu et al. [35] involving dentistry students in Turkey, 63.3% of participants reported that they had previously heard of CBCT. In the present study, 51.8% of students stated that they were aware of the use of CBCT in orthodontics. Furthermore, a statistically significant association was found between academic year and CBCT awareness, with a higher proportion of fifth-year students reporting awareness of CBCT use (p < 0.05). This finding may be explained by the fact that, in upper years, students are introduced to the clinical significance of CBCT in orthodontic diagnosis courses—particularly in topics such as the evaluation of skeletal anomalies, localization of impacted teeth, detailed analysis of maxillofacial structures, and planning of orthognathic surgery [36, 37]. Additionally, fifth-year students are more likely to encounter CBCT imaging across various clinical rotations—such as orthodontics, prosthodontics, and oral surgery—thereby gaining broader familiarity and practical insight into its application.

The field of orthodontics has undergone a significant transformation with the integration of 3D printing technology in the production of clear aligners manufactured by various brands. In a study conducted among dentistry students in Saudi Arabia, 64.0% of participants reported being aware of the role of 3D printing in the clear aligner system [21]. Similarly, in the current study, 91.7% of students stated that they were aware that clear aligners used in orthodontics are produced using 3D printing technology. This rate is particularly noteworthy, reflecting the high level of awareness among dentistry students in Turkey regarding digital manufacturing. The growing popularity of clear aligner treatments, both locally and globally, along with their frequent promotion on social media, has likely increased students’ exposure to and interest in this technology. While most students were aware that clear aligners are produced using 3D printing technology, significantly fewer recognized its application in the fabrication of other orthodontic components—only 29.1% reported awareness of 3D printing being used to produce orthognathic surgical splints, expansion appliances, and other customized devices, and just 30.2% were aware of its use in manufacturing individualized arch wires and bracket systems. This gap in awareness may stem from the absence of a 3D printer in the university’s orthodontic clinic and the fact that such appliances are typically fabricated by dental technicians in external laboratories, limiting students’ exposure to these processes. One of the most noteworthy findings was that awareness regarding the use of 3D printing technology for the fabrication of orthodontic appliances was highest among third-year students, reaching 43.3%. This rate declined to 15.5% in fourth-year students and 27.3% in fifth-year students (p < 0.05). Similarly, awareness of the use of digital software for diagnosis and virtual treatment planning also showed a decreasing trend, with 43.3% of third-year students reporting awareness, compared to 30.9% in fourth-year students and 24.7% in fifth-year students (p < 0.05). These results may be better understood within the context of curricular timing and instructional structure. In Turkey, theoretical orthodontic education is delivered during the third and fourth years, while the fifth year focuses more on clinical internships. If digital technologies introduced during theoretical training are not sufficiently reinforced through clinical exposure, fewer students may report awareness by their final year. For example, technologies such as CBCT or clear aligners may be more frequently encountered in clinical settings, while digital planning software or 3D-printed appliances may be less commonly used or demonstrated. This highlights the need for enhanced integration of theoretical and clinical instruction to promote continuity in digital technology education within orthodontics.

In the present study, 87.1% of students reported being aware of the use of intraoral scanners in orthodontic practice. This finding is not unexpected, as intraoral scanners are increasingly utilized to obtain digital impressions not only in orthodontics but also in prosthodontics and other fields of dentistry [38]. In many regions of the world, the specialty of orthodontics is not typically practiced by general dentists. This may influence students to gravitate toward digital technologies that are more widely used in general dental practice. As intraoral scanners have become a common tool across various disciplines, their frequent use may explain the higher levels of awareness reported by students, regardless of their specific interest in orthodontics. Similar results have been reported in Germany, where studies conducted by Schott et al. and Wegner et al. demonstrated high levels of awareness and positive attitudes among dental students regarding digital impression techniques in both clinical and preclinical settings [39, 40]. Similar to our findings, a recent study conducted among dental interns and practitioners in Saudi Arabia also reported a high level of awareness regarding intraoral scanners, despite limited clinical usage [41]. Moreover, the routine use of intraoral scanners in the orthodontic clinic where this study was conducted may have contributed to this high level of awareness. Notably, the observed increase in awareness with higher academic levels may be attributed to the accumulation of clinical experience and more frequent interaction with digital tools during patient care in the later years of dental education. The findings of Nakornnoi et al. [26] highlight that postgraduate orthodontic residents perceive intraoral scanners, CBCT, and digital planning software as both essential and confidence-inspiring tools within clinical orthodontics. These technologies were deemed mandatory in orthodontic postgraduate programs, whereas other applications such as in-office aligners or CAD/CAM were viewed as less critical and more suitable for short-course training. In line with these findings, our study revealed that even at the undergraduate level, intraoral scanners had the highest recognition rate (87.1%), while technologies like teledentistry or custom appliance fabrication via 3D printing showed much lower awareness. Intraoral scanners and CBCT have become increasingly common in orthodontic workflows, reflecting broader digital integration trends in clinical dentistry [42]. Findings in the present study align with broader trends reported in research involving postgraduate residents and practicing dentists. For instance, Nakornnoi et al. [26] emphasized that orthodontic residents perceive intraoral scanners, CBCT, and digital planning software as indispensable tools, whereas Van der Zande et al. [43] showed that adoption of digital technologies among general practitioners remains variable and strongly influenced by clinical responsibilities and infrastructure. Similarly, Alqahtani et al. [41] and Khalil & Sirri [44] highlighted that awareness of intraoral scanners is consistently high across different educational and geographic contexts, despite challenges in clinical utilization. These comparisons underscore those undergraduate students, despite their limited clinical experience, display awareness patterns that overlap with those observed among residents and practitioners, highlighting the critical role of curricular structure and early clinical exposure in shaping digital literacy in dentistry.

Teledentistry in orthodontics refers to a method of delivering care that facilitates remote diagnosis, treatment monitoring, and professional consultation, thereby enhancing accessibility and efficiency in orthodontic services [45]. Especially during the COVID-19 pandemic, it emerged as an effective alternative to face-to-face visits for orthodontic practices [46]. In a study conducted with dentistry students in Saudi Arabia, 17.2% of the participants had previously heard of teledentistry [23], whereas Boringi et al. [22] reported that 27.37% of dental professionals, including dentistry students, had heard of teledentistry. In a more recent study, Akçiçek et al. [7] reported that 37.9% of undergraduate dentistry students had heard of teledentistry. Similarly, in our study, 34.5% of dentistry students reported that they had heard of teledentistry within the context of orthodontics. Variations in awareness may stem from differences in national digital health infrastructures, curricular inclusion of teledentistry, and students’ levels of clinical exposure. While Akçiçek et al. [7] highlighted the impact of a dedicated teledentistry course on student awareness, the observed awareness in our study—despite the absence of such a course—may reflect the lasting influence of the pandemic on educational and clinical practices.

It has been stated in the literature that a considerable number of dentists continue to rely on knowledge and skills acquired during earlier stages of their education and tend to resist incorporating recent scientific advancements into their routine clinical practices [47]. The results of this study revealed generally positive student attitudes toward the use of digital tools in orthodontics. Notably, a majority of participants reported favorable views regarding digital advancements, with 41% agreeing and 24.5% strongly agreeing with the integration of such technologies into orthodontic treatment. Additionally, over 80% of respondents believed that these developments benefit both patients and practitioners, and more than two-thirds supported the inclusion of digital technologies in both undergraduate (68.4%) and postgraduate (51.4%) dental education. These findings are consistent with previous studies demonstrating a growing interest in digital dentistry among both dental professionals and students. For instance, Acharya et al. [48] reported that 98.9% of dental professionals expressed interest in 3D printing technologies, indicating a broad acceptance of digital innovation in clinical practice. Similarly, Alamri et al. [21] reported that 82.4% of dental students expressed a strong desire to further explore 3D printing applications, highlighting that students showed a compelling willingness to engage with emerging digital technologies. Higher agreement among fifth-year students on the impact of digital advancements may reflect the influence of accumulated clinical exposure. Additionally, the stronger endorsement by third- and fifth-year students for postgraduate training in digital orthodontics underscores the recognized need for continuous, structured education at both early and advanced stages of dental education. This question aimed to examine whether students’ intended dental specialties are associated with their awareness and attitudes toward digital orthodontic technologies. Students aiming for orthodontics or pediatric dentistry also showed greater endorsement of digital technologies’ role in specialty choice and postgraduate education, likely due to earlier and more intensive exposure required in these fields.

This study highlights differences in awareness between digital tools commonly used in general dental practice, like intraoral scanners, and advanced applications more specific to orthodontics. These differences may be influenced by the structure of dental education in Turkey, where orthodontics is taught theoretically during the third and fourth years, with clinical exposure concentrated in the final year. If theoretical content is not adequately reinforced through hands-on experience, awareness of certain technologies may decline over time. Although the effect sizes for the observed differences were small to moderate, these findings still suggest educational patterns that may impact students’ readiness to adopt digital tools in clinical practice. Furthermore, the timing of digital technology instruction and variability in institutional resources across Turkey may also play a role. In some universities, limited access to advanced equipment—such as 3D printers or treatment planning software—can restrict students’ exposure to emerging orthodontic applications. However, it should be noted that this study was conducted at a university that offers postgraduate orthodontic education. Universities without postgraduate programs often operate with more limited resources, which may hinder the integration and understanding of advanced digital tools and applications among students. This factor may influence the quality of undergraduate digital education and warrants further investigation in future research.

This study is subject to several limitations. Primarily, the single institution setting of this study may limit the generalizability of the findings to dental students from different educational environments, institutional contexts, or cultural backgrounds. While such sampling is frequently employed in exploratory research within dental education, future multi-center studies are recommended to enhance external validity and provide a more comprehensive representation of the target population. Secondly, the cross-sectional nature of the study provides a snapshot of students’ awareness and attitudes at one point in time, thereby preventing conclusions about how these perceptions may change with continued curricular exposure or clinical experience. Thirdly, the reliance on self-reported data may introduce response biases, such as social desirability or recall bias, which could affect the accuracy of the findings. Lastly, while students reported favorable attitudes toward digital orthodontic technologies, the extent to which these translate into clinical practice remains unclear. Longitudinal, multi-center studies are recommended to address these limitations and enhance external validity. Additionally, as the study was conducted in an institution offering a postgraduate orthodontics program, generalizability to dental schools without such programs may be limited.

Conclusion

The findings revealed variation in student responses regarding specific digital orthodontic applications. The most frequently recognized topics were 3D printing technologies for clear aligner production and the use of intraoral scanners in orthodontic practice. Fewer students reported familiarity with digital software for diagnosis, teledentistry applications and the fabrication of customized orthodontic devices using 3D printing technologies. Notable differences in recognition of certain applications, such as CBCT usage, in-office aligner production, 3D printing of appliances and digital treatment planning tools, were observed between academic years, whereas recognition levels for intraoral scanning, 3D-printed aligners, customized appliances and teledentistry remained relatively consistent. Attitudinal responses generally indicated agreement on the benefits and necessity of integrating digital technologies into orthodontic education and practice. To support the preparedness of future dental professionals for evolving clinical environments, educational strategies should be structured in alignment with current clinical demands and the ongoing advancements in dental technology. In particular, integrating early clinical exposure to advanced digital tools may enhance student familiarity and ensure more effective adaptation to modern orthodontic practices. Curricular frameworks should include longitudinal integration of digital planning tools, supported by hands-on training in the final year to bridge theory and clinical practice.

Data availability

The complete dataset generated and analyzed during the current study is available from the corresponding author upon reasonable request without restrictions.

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