QUALITY AND RELIABILITY ASSESSMENT OF YOUTUBE VIDEOS ON ZIRCONIA CROWNS: A CROSS-SECTIONAL STUDY

INTRODUCTION

With the increasing use of the internet, individuals have increasingly turned to internet-based search engines and social media to obtain information. Because the internet provides access to a wide range of topics, these platforms have become attractive to patients seeking health-related information and are perceived as useful resources AlGhamdi and Moussa (2012). Increased internet use has facilitated easy access to existing online health information and has led to the emergence of healthcare users who are more likely to become informed through such access. This, in turn, contributes to individuals’ understanding of medical and dental treatments Thapa et al. (2021).

In addition to face-to-face physician–patient interaction, patients’ hesitation to ask questions in person, together with the convenience of immediate access to medical information online despite waiting times in clinics, encourages individuals to seek information on social media platforms Gholami-Kordkheili et al. (2013). More than 80% of internet search activity is related to obtaining medical information and support Madathil et al. (2015). Nevertheless, internet users may not always possess sufficient skills to assess the accuracy of information available on social media or to relate such information appropriately to their own health conditions Korkmaz and Buyuk (2020).

The ready accessibility of websites capable of providing information to patients enables them to make more informed health-related decisions. YouTube is one of the most frequently visited websites by patients seeking access to medical information and is the second most popular website on the internet after Google Bezner et al. (2014). Founded in 2005 as a video-sharing platform, YouTube currently receives billions of video views, and users spend a considerable amount of time on the platform daily Findik and Buyukcavus (2020). On YouTube, patients and professionals can share experiences, symptoms, or treatments through videos accompanied by various tags. However, this also creates a serious risk of misinformation and misdirection Madathil et al. (2015).

Zirconium is a transition metal element with atomic number 40 and does not occur freely in nature but rather in compound form. The most common compound is zirconium dioxide Piconi and Maccauro (1999). Zirconium oxide crystals exist in three phases: cubic, tetragonal, and monoclinic Burger and Willmann (1993).

The first reported medical use of zircon materials dates back to the late 1960s Helmer and Driskell (1969). Zirconia later became widely used in the biomedical field, and zirconia crowns were introduced in the early 2000s as an alternative restorative material Alzanbaqi et al. (2022). Zirconia is a dental ceramic with high flexural strength and fracture toughness and has long been used as a framework material or in monolithic form Stawarczyk et al. (2017). With increasing esthetic expectations, the use of zirconia crowns has expanded. One of their main advantages is their favorable esthetic appearance in addition to durability Walia et al. (2014), Planells del Pozo and Fuks (2014). Moreover, due to their highly polished surfaces, zirconia crowns demonstrate lower bacterial retention compared with alternative materials Taran and Kaya (2018), Abdulhadi et al. (2017).

This study aimed to evaluate the content and reliability of YouTube videos related to zirconia crowns in the context of oral rehabilitation.

MATERIALS AND METHODS

This study was conducted using publicly available data and did not involve human subjects; therefore, ethical approval was not required.

The YouTube search was conducted on February 5, 2025, using the keyword “zirconia crowns.” The most frequently used related terms were identified as “zirconia crowns” and “zirconia teeth.” The search was performed using a clean browser and a newly created account to minimize personalization. Videos were screened from the most relevant results.According to Google Trends, “zirconia crowns” was the most commonly used search term for this topic.

Only the default YouTube search filter (“sort by relevance”) was applied. A new user profile was created, and browser history and cookies were cleared prior to the search. The search results were listed according to video relevance. Inclusion criteria for the videos were as follows: Turkish language; content related to zirconia crowns; and acceptable audio and video quality. Exclusion criteria were as follows: language other than Turkish; videos longer than 35 minutes; videos with poor audio and video quality; and videos showing procedures performed in a patient’s mouth without providing any information.

The first 50 videos were screened, and the first 20 videos meeting the inclusion criteria were included in the analysis.

The number of views, comments, likes, video duration, source, and publication date were recorded. Based on these data, the viewing rate of each video was calculated Figure 1.

Figure 1

Figure 1 Formula Used to Calculate the Viewing Rate.

The videos included were evaluated by a single researcher specializing in prosthodontics according to the information-quality assessment criteria defined by Hegarty et al. (2017). The videos were categorized into three groups based on information quality: poor, moderate, and good. Videos containing accurate, high-quality, and useful information for patients were classified as “good.” Videos that provided partially adequate information but had limitations in presentation quality were classified as “moderate.” Videos containing misleading information or providing no benefit to patients were classified as “poor” Hegarty et al. (2017).

To improve consistency, 20% of the videos were re-evaluated after a two-week interval by the same researcher.

STATISTICAL ANALYSIS

Statistical analysis was performed using SPSS version 26.0. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to evaluate the data. One-way analysis of variance (ANOVA) was conducted to assess differences among video categories. A p-value of < .05 was considered statistically significant.

RESULTS

Of the 20 videos, 12 were uploaded by dentists, 4 by clinics, 3 by patients, and 1 by a university Figure 2. Among the analyzed videos titled “Zirconia crowns,” the minimum and maximum numbers of views were 5,773 and 554,654, respectively, with a mean of 152,353±132,001; the number of comments ranged from 3 to 945, with a mean of 251±248; video duration ranged from 0:27 to 30:23, with a mean of 6:30±7:40; and the number of likes ranged from 55 to 846, with a mean of 289.4±253.62. The mean viewing rate was 41,118±36,318 Table 1.

The videos analyzed were further evaluated according to Simsek et al. (2020) and were compared by grouping them according to the information-quality categories used in the study by Hegarty et al. (2017) Table 2.

Figure 2

Figure 2 Sources of Uploaded Videos.

Table 1

Table 1 Video Characteristics.
Variable	Mean ± SD	Minimum	Maximum
Views	152,353 ± 132,001	5,773	554,654
Comments	251 ± 248	3	945
Duration	6:30 ± 7:40	0:27	30:23
Viewing rate	41,118.3 ± 36,318.5	1,724	122,618
Likes	289.4 ± 253.6	55	846

Table 2

Table 2 Comparison of YouTube Videos According to Content Quality.
Variable	Good	Moderate	Poor	p
Views	118,245 ± 66,479.2	108,033.6 ± 88,108.6	227,366.5 ± 181,715.9	0.178
Comments	254 ± 185.3	141.6 ± 129.5	375 ± 345.6	0.199
Duration	8:35 ± 05:01	06:38 ± 05:43	07:11 ± 11:04	0.662
Viewing rate	31,065.6 ± 21,794.2	48,727.2 ± 41,943.7	39,602.7 ± 40,542.4	0.711
Likes	317.2 ± 267.5	168.7 ± 113.7	407.5 ± 323.3	0.188
Note. Data were analyzed using one-way ANOVA. Statistical significance was set at p < .05.

DISCUSSION

In recent years, with the increasing popularity of the internet and social media, more individuals have incorporated online information into their decision-making processes. Studies have shown that 86% of individuals who use the internet to obtain health-related information consider such information reliable, and 64% report that it influences their medical decisions DiMaggio et al. (2001), Morr et al. (2010). Furthermore, Baker et al. (2010) reported that younger patients (<50 years) have significantly greater internet access and are more likely to use the internet to research their health conditions.

It is reasonable to assume that YouTube is among the primary platforms consulted by patients interested in zirconia crowns. Compared with other social media platforms, YouTube provides more influential visual content. Consequently, many patients, even after receiving information from dentists, turn to YouTube either for initial or supplementary information.

However, the reliability of information on YouTube remains questionable, as video content is not standardized and can be uploaded easily. It has been reported that 33% of individuals consider the most popular health-related information sources to be reliable Nason et al. (2013). At the same time, the presence of non–evidence-based information and the ability of non-professionals to upload content raise significant concerns. Previous studies have shown that a substantial proportion of health-related videos originate from amateur sources Hegarty et al. (2017), Zincir et al. (2019).

In the present study, YouTube users demonstrated considerable interest in zirconia crown–related videos. Both professionals and non-professionals contributed a large number of videos, many of which had high view counts. Users frequently interacted with videos by sharing their experiences and opinions in the comments.

It was observed that videos with high-quality information were predominantly uploaded by professionals, whereas those with moderate or poor information quality were more commonly uploaded by non-professionals. Additionally, most videos were found to have low or moderate information quality, which is consistent with previous studies evaluating YouTube content on health-related topics.

Interestingly, the longest videos were categorized as having poor information quality. This may be attributed to the inclusion of non-relevant personal content in videos uploaded by non-professionals. Moreover, the most-viewed videos were also frequently found in the poor-quality category. These findings are consistent with those reported by Simsek et al. (2020).

These results suggest that YouTube relevance algorithms do not necessarily reflect the actual quality of video content. The evaluation conducted by a prosthodontics specialist revealed that a significant proportion of videos contained misleading or insufficient information. Such content may negatively influence patient behavior by increasing the risk of misinformation. Furthermore, when online information conflicts with the scientific information provided by clinicians, it may reduce patients’ trust or lead to skepticism regarding recommended treatments.

On the other hand, due to the dynamic nature of YouTube, search results and recommended videos may change over time. Users’ preferences and viewing behaviors, along with algorithmic modifications, directly influence content visibility. Therefore, the reliability and continuity of information on YouTube should be interpreted with caution.

Furthermore, the findings of this study have important clinical implications. Patients who rely on inaccurate or misleading information from online platforms may develop unrealistic expectations regarding zirconia crown treatments. This may negatively affect the dentist–patient relationship, treatment acceptance, and overall clinical outcomes. Therefore, improving the quality of online educational content is not only essential for information accuracy but also critical for maintaining patient trust, improving treatment acceptance, and ensuring effective clinical outcomes in modern dental practice.

CONCLUSION

YouTube cannot be considered a reliable source of information for patients regarding zirconia crown restorations. Reliable information is still primarily provided by dental professionals. Therefore, more dentists and/or clinics should upload videos to YouTube presenting their views and informative details about zirconia crown restorations. Dental professionals should take a more active role in producing evidence-based educational video content to improve the quality of information available to patients on social media platforms. Future studies with larger sample sizes and multiple evaluators are recommended to enhance the generalizability of the findings.

ACKNOWLEDGMENTS

None.

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