Radiographic Diagnostic Competence for Marginal Discrepancies in Fixed Dental Prostheses

Background: Marginal adaptation is a key determinant of the biological, functional, and esthetic longevity of fixed dental prostheses. Inadequate margins increase the risk of secondary caries, periodontal inflammation, and restoration failure. Radiographic detection of marginal discrepancies is essential, yet diagnostic accuracy varies with clinical experience and training. Objective: To assess the awareness, diagnostic accuracy, and self-perceived confidence of dental students, interns, and practitioners in identifying marginal discrepancies in crowns and FDPs through radiographic analysis. Methods: A cross-sectional, questionnaire-based survey was administered to 4th and 5th-year dental students, interns, and practitioners. The validated instrument, designed in accordance with the CROSS checklist, comprised demographic data, perception and awareness items, and radiographic image-based diagnostic tasks. Standardized periapical and bitewing radiographs were obtained from institutional patient records and verified by three expert examiners to ensure diagnostic uniformity. Descriptive statistics summarized response patterns, while Chi-square and one-way ANOVA tests compared diagnostic accuracy and confidence across groups. Results: Among 161 valid responses, practitioners achieved significantly higher diagnostic accuracy (53.7% ± 11.3) and confidence (4.00 ± 1.15) than students (45.8% ± 15.3) and interns (34.6% ± 23.5) (p < 0.01). Open and contour discrepancies were least accurately identified. Conclusion: Although participants recognized the clinical importance of radiographic assessment, diagnostic proficiency gaps were evident, particularly among less experienced groups. Structured case-based training and integration of digital diagnostic tools may improve interpretive accuracy and reduce complications related to marginal discrepancies in fixed dental prostheses.