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 Table of Contents  
Year : 2022  |  Volume : 9  |  Issue : 2  |  Page : 136-142

Youtube as an Information Source for Practitioners on Direct Diastema Closure Procedures

Department of Restorative Dentistry, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

Date of Submission16-Dec-2021
Date of Decision01-Jul-2022
Date of Acceptance01-Dec-2022
Date of Web Publication22-Aug-2022

Correspondence Address:
Mehmet Buldur
Department of Restorative Dentistry, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale 17020
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdrr.jdrr_189_21

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Background: The aim of the study was to analyze the content and quality of clinical diastema closure videos related to the direct resin composite restoration technique available on YouTubeTM. Materials and Methods: The videos were determined using the words “diastema closure,” “teeth gap fill,” and “teeth gap close” in the YouTube™ search section. 300 videos were reviewed, and 55 of them were included in the study. Demographics of videos, interaction index, and viewing rates were evaluated. The videos were analyzed in three parameters in terms of content score (CS), technical features (TF), and global quality scale (GQS). Results: The dentist accounts took the first place (51%) in the distribution of those who uploaded the videos. The mean values of the videos from the evaluation criteria were 8.3/15p for CS, 3.1/5p for TF, and 2.7/5p for GQS. There was a statistically significant positive correlation between the viewing rates, TF, and GQS values (P < 0.05). Conclusion: Operational videos of diastema closure with direct composite resin restoration treatments should be uploaded to YouTube™ after approval by experts. In addition, the TF of operational videos needs to be better. Students should be warned about videos which contain insufficient information.

Keywords: Dental education, diastema, E-learning, social media, YouTube

How to cite this article:
Buldur M, Misilli T. Youtube as an Information Source for Practitioners on Direct Diastema Closure Procedures. J Dent Res Rev 2022;9:136-42

How to cite this URL:
Buldur M, Misilli T. Youtube as an Information Source for Practitioners on Direct Diastema Closure Procedures. J Dent Res Rev [serial online] 2022 [cited 2022 Oct 2];9:136-42. Available from: https://www.jdrr.org/text.asp?2022/9/2/136/354199

  Introduction Top

Dental faculties have been heavily affected by the COVID-19 pandemic due to the very high risk of exposure to the virus (severe acute respiratory coronavirus virus 2 [SARS-CoV-2]), particularly by dentists, including dental students who receive hands-on clinical training. For this reason, lectures and practical training were suspended, and e-learning methods were intensified by helping ongoing educational activities.[1] The definition of e-learning is “to use electronic technologies to access the curriculum outside of traditional classroom education.”[2] These days, blended learning and e-learning, are gaining popularity as successful and revolutionary teaching styles [Figure 1].[2],[3],[4],[5],[6],[7] The content of educational documents available online is infinitely greater than other well-known sources. However, many of these online accessed materials do not undergo expert review.[8]
Figure 1: Graph of the frequency of searching for the term “E-learning” by YouTubeTM users around the world in the past 5 years

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The digital literacy rate, online socialization, teamwork, and visual interactions of today's students are quite high.[3],[4],[9] They often use the Internet to find additional educational content for their learning process.[10],[11] One of the methods chosen to access information is to use online video sharing platforms.[11],[12] Various studies in both dental and medical education report that YouTubeTM is the most frequently used digital resource/application by health-care professional students.[11],[13],[14] Visual representation of clinical procedures is considered to be an important advantage of e-learning.[15],[16] It was stated that 3rd and 4th year dental students were mostly YouTubeTM users and that, although education was not the primary purpose of their use of YouTubeTM, they were very likely to use YouTubeTM as a resource to learn and prepare for clinical dental procedures.[17] However, most of the e-learning content available on the internet may not have been prepared by dentists or dental educators. The videos, classified under the category of education, were evaluated as useful by professionals or laypeople.[18] However, most of the videos defined in the education category are not as reliable as expected for many reasons.[19],[20] The literature on the use of video-sharing platforms as a complementary learning tool in dentistry is limited. In a study, it was stated that 97.5% of the students learned clinical procedures over the internet. Students usually obtain these videos with the help of Google (77.7%) and/or by watching YouTubeTM videos (93.2%). More importantly, students often share the content with their friends, but only 13% discuss it with educators. This situation reveals that dentistry students have access to unreliable information, which consequently creates a problem in dental education.[11]

A gap of more than 0.5 mm between the contact teeth is defined as diastema.[21] It is defined as “midline diastema” between the maxillary central teeth and “polidiastema” when it occurs between a group of teeth over the arch.[22] Diastema may occur due to mesiodens or hypodontics; the size of the teeth (microdontia); enlarged and hypertonic labial frenulum; harmful habits that misplace the tongue; periodontal problems; and cystic formations. Diastema closure treatment can be successfully performed with orthodontic methods and direct/indirect restorative treatments.[23]

There is no study in the literature that analyzes diastema closure treatment procedures with direct resin composite restorations in YouTube™ video contents. The objective of this study was, therefore, to analyze the content and quality of mid-line and polidiastema closure videos available on YouTubeTM and to include operative procedures with direct resin composite application methods.

  Materials and Methods Top

The research was designed as a cross-sectional study. The study videos consisted of YouTube™ (https://www.YouTube.com) videos containing operational videos on diastema closure with direct composite resin restorations. The screening took place between 09.00 and 18.00 on April 14, 2021. A new account was created before the search, and the historical data and cookies of the computer used were deleted. The search filter used was the default filter, “Sort by relevance.”

The videos were determined using the words “diastema closure,” “teeth gap fill,” and “teeth gap close” in the YouTube™ search section [Figure 2]. It is stated that most of the users search for the first 60–200 videos on YouTube.[24] In this study, we included the top 100 videos for each search term. The videos were evaluated by the researchers (M. B. and T. M.) without seeing each other's answers. When there were differences between the researchers during the evaluation process, a consensus was made with references to the literature. Since the research was conducted on public internet data, it was decided that ethics committee approval was not required.
Figure 2: A comparative search of Google Trends for treatment options from the day “E-learning” [Figure 1] searches started to increase, using “Worldwide” and “YouTubeTM” filters

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The number of views, duration, number of comments, number of likes and dislikes, and upload date of each video included in the study were used. The viewers' interactions were calculated based on the Interaction index ([number of likes − number of dislikes]/total number of views ×100%) and the Viewing rate: (number of views/number of days since upload ×100%).

The videos were analyzed in three different parameters in terms of “Clinical Stages” for restoring anterior teeth using direct composite content score (CS),[25]

“Technical Features (TF)” of the videos TF, “Global Quality Scale (GQS).”

The videos were graded between 1 and 15p for each clinical stage according to the points they got from the criteria specified in the section and 1–5p for the TF qualities. In this context, while they got 1 point for each criterion shown or mentioned in the video, they could not get any points from the wrong application or missing criteria in the video [Table 1]. Finally, the overall quality of the videos was subjectively scored by both researchers using a 5-point Likert-type GQS:
Table 1: Content and technical features rating scales

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  1. Poor quality, incomplete information, poor video streaming, not useful for practitioners
  2. Generally, poor quality and poor flow, missing many important points, limited use for practitioners
  3. Moderate quality, some important information is adequately discussed, suboptimal flow, somewhat useful for practitioners
  4. Good quality and generally good flow, most of the relevant information is listed, useful for practitioners
  5. Excellent quality and flow, very useful for practitioners.

In this study, the descriptive statistics (number, percentage, minimum, maximum, average and standard deviation) of the data are given. As the first step in analyzing the data, the assumption of normality was checked with the Shapiro–Wilk test. ANOVA test was used to examine the difference between the means of three or more independent and normally distributed groups. The Kruskal–Wallis test was used to examine the difference between the averages of three or more independent and nonnormally distributed groups. Bonferroni post hoc test was performed to identify the group or groups that made the difference. In order to examine the relationship between continuous variables, Spearman correlation was used when the normal distribution assumption was not met. The analyzes were carried out in IBM SPSS version 25 (IBM Software Group, Chicago, IL, USA).

  Results Top

As a result of the researchers' investigations, 245 videos were excluded from the study [Figure 3]. Of the remaining 55 videos, 39 (71%) included mid-line treatment, whereas 16 (29%) included polidiastema treatment. The dentist accounts took the first place in the distribution of the uploaders of the videos [Figure 4]. Descriptive analyzes are as stated in [Table 2]. The mean number of views of the videos was 192,481. The mean video duration was 6 min, whereas the mean number of “likes” was 1,035 and the number of “dislikes” was 60. The mean number of comments was 83. The most-watched video (5,091,483) was about mid-line diastema treatment and belonged to the dentist account. It was also the most liked, disliked, and commented video with the highest view rating. The video with the highest Interaction index was also about a mid-line diastema treatment belonging to a dentist account and was watched 691 times.
Figure 3: Flowchart showing video selection

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Figure 4: Distribution of video uploaders as stated on YouTube

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Table 2: Descriptive statistics for continuous variables

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The distribution of the videos was determined according to the scores they got from 3 different evaluation criteria [Table 3]. The groups that got 9–10 points from the content scoring (n = 13, 23.6%), 3 points from the TF score (n = 22, 40%), and 2 points from the GQS score (n = 17, 30.9%) are the subgroups with the highest number of videos. All the videos with a full score on the GQS are related to mid-line diastema treatment. Most of these videos (n = 5) are from dentist/clinic/university accounts.
Table 3: Descriptive statistics for categorical variables

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In the evaluation made according to the scores they got from the GQS, the videos were divided into 5 groups [Table 4]. A statistically significant difference was found between number of views, video duration, number of likes, dislikes, number of comments, view rate, and CS in terms of mean values (P < 0.05).
Table 4: Comparison of global quality score groups in different evaluation criteria

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According to the analysis result, the correlation between the Viewing rate and the GQS was positive, and a moderate and statistically significant relationship was found between them (P < 0.05). The correlation between the Viewing rate and the TF score was positive, and a weak and statistically significant relationship was found between them (P < 0.05) [Table 5].
Table 5: Relationship of variables with global quality, content, and technical feature scores

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  Discussion Top

The videos in the study were mostly uploaded from dentist or health-care institutional accounts. This situation is expected and desired from operational dentistry videos. There are studies stating that mostly professionals share videos on a subject related to their field of expertise.[26],[27],[28] Interestingly, there are studies where laypersons share more videos about dentistry.[29],[30] However, the number of educational videos in the study is low. In addition, the presence of videos from nonprofessional accounts is a dangerous situation for the education of students.

The mean value of view numbers is high, but the mean duration of the videos for the clinical procedures that are the subject of the study is short. The fact that there are 10-year and 1-week videos in the study show that this platform has been used for this purpose for a very long time and is still actively used. The mean interaction index value of the study gave a result close to the findings of a similar study evaluating the quality of medical information about COVID-19, and the mean viewing rate was close to the findings of the study evaluating the content, reliability, and quality of the videos about orthodontic clear aligners.[30],[31] The GQS scores of the videos are an independent overall assessment not linked to CSs and TF. Although it does not get full points from content or technical evaluation, there are videos that get full points from the GPS. However, more than half (72.7%) of the videos have medium and/or low GQS. Likewise, there are many insufficient videos in terms of content and technical feature values, which may cause wrong or incomplete information to the students watching the videos on the subject. Similar to our research, there are studies in which useless videos are in the majority.[30],[31]

There are statistical differences between the mean values of the subgroups formed according to the scores they received from the GQS in terms of some parameters. However, the groups are similar in terms of interaction index and technical feature mean values. The mean values of the videos (n = 7), which received full points from the GQS evaluation in terms of number of views, likes, comments, and viewing rates, are lower than the general mean values of these parameters in the study. It is noteworthy that the group with the lowest mean value of viewing rate was the group that got full points from the GQS. These videos, which provide students with the highest level of information, should have a higher number of views.

It is seen that the mean values of the technical properties are similar and average in all groups. It is an important issue that the audio-visual quality and video resolution are as good as the accuracy of the information contained in the operational dentistry videos. At the same time, the videos must have a subtitle option. The presence of hashtags (#), one of the technical evaluation parameters, has not been examined in other YouTube™-related studies before. The viewer can easily access other videos related to the subject through the hashtags tool in the video. In addition, it was thought that it would be beneficial for the audience to have short explanations about the process done in the video, to mention the materials used and to have contact information in the explanation section under the video. The positive correlation between viewing rates and TF shows that positive TF affect the behavior of viewers. The same parallelism exists in the GQS evaluation, though weak. This correlation should be more. Monitoring of operational dental procedures, including clinical applications, from video sharing sites, is not a substitute for clinical practice training but is a very important part of visual interaction practice training. It was stated that students used written and visual web tools for this purpose.[11],[17] Videos that are useful in terms of content and information should also have high interaction and viewing rates. Videos with high-quality content should be met with students, and videos with incorrect and incomplete information should be prevented from interacting and watching.

As YouTube is a dynamic platform, video content can change from day to day, which can affect search results. There may be differences in search results as new videos are added every day or old videos are deleted. Search results may vary based on the video's interaction and time. Therefore, the limitation of the current study is that the data collection method is instantaneous, as in similar studies. Another limitation is the keywords used when specifying the videos of the work. However, users may find different videos and different results with other search terms. In addition, since the operational processes that are the subject of the study are common all over the world, the evaluation of the videos only in English is among our limitations. Furthermore, since there is no filtering opportunity regarding the career status of the viewer on such platforms, it could not be determined whether the viewers consisted only of dental practitioners. In further studies, with the reshaping of distance education (e-learning, blended learning, etc.) during the pandemic period, different social media tools used by students should be investigated on other subjects of dentistry education.

  Conclusion Top

Although social media provides a great advantage in terms of reaching a large student population, it can also easily cause false information to spread with the same method. Operational videos of diastema closure with direct composite resin restoration method should be uploaded to YouTube™ after approval by experts. In addition, the TF of operational videos needs to be better. There are videos containing current literature information in the study, but the rate of these videos should be increased. Students should be warned about videos which contain insufficient information. More studies are needed to investigate the content quality of dental educational videos on different social media platforms.

Ethical clearance

Since the present study is an observational study as it involved the use of public access data only, there is no need for approval of the ethics committee. Similarly, ethics committee approval was not required in studies investigating the relationship between social media and dentistry.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10]

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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  [Figure 1], [Figure 2], [Figure 3], [Figure 4]

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


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