Prosthodontists' perceptions of occlusal and psychosocial etiologies in temporomandibular disorders and their impact on clinical satisfaction: A latent variable structural equation modeling analysis.

STATEMENT OF PROBLEM: A persistent divergence exists in prosthodontics between research-supported biopsychosocial frameworks and traditional occlusal perspectives on temporomandibular disorder (TMD) etiology, shaping clinical approaches and satisfaction.

PURPOSE: This study aimed to analyze the latent cognitive structures of prosthodontists by examining relationships between clinical experience, etiological beliefs (occlusal and psychosocial), and satisfaction in managing TMDs.

MATERIAL AND

METHODS

A cross-sectional survey of 124 prosthodontists was analyzed using latent variable structural equation modeling (SEM). Confirmatory factor analysis validated reflective constructs for occlusal and psychosocial etiology beliefs and use of technical modalities. Clinical experience was a formative composite. The structural model tested pathways from experience to beliefs and then to management satisfaction.

RESULTS

A strong negative covariance confirmed a dichotomy between occlusal and psychosocial beliefs. Greater clinical experience predicted stronger occlusal beliefs (β=.226, P<.001) and weaker Psychosocial beliefs (β=-.257, P<.001). For early-stage TMDs, occlusal beliefs (β=.91, P=.028) and psychosocial beliefs (β=.59, P=.014) both predicted higher satisfaction. For late-stage TMDs, psychosocial beliefs strongly negatively impacted satisfaction (β=-1.00, P=.004).

CONCLUSIONS

Occlusal and psychosocial beliefs function as competing paradigms. Clinician satisfaction was profoundly mediated by these beliefs, with an occlusal orientation linked to higher early-stage satisfaction. A psychosocial orientation predicts significantly lower satisfaction in managing chronic TMDs. Bridging this belief gap through integrated education is crucial for effective TMD management and clinician well-being.