Developing an Original Methodology for Multi-Criteria Decision Analysis in Dental Material Selection for Nigerian Clinical Contexts

Dental material selection in Nigerian clinical practice involves complex trade-offs between clinical performance, cost, material availability, and environmental considerations that single-criterion decision frameworks cannot adequately address, and developing an original multi-criteria decision analysis methodology for dental material selection provides a rigorous tool for evidence-based practice. This study developed and validated an original multi-criteria decision analysis methodology for dental material selection tailored to Nigerian clinical contexts, with application to posterior restorative material selection as the primary decision domain. A methodology development approach was employed, drawing on systematic review of MCDA in healthcare decision-making (48 publications from 2018 to 2024), structured elicitation of criteria weights from 80 Nigerian dentists using discrete choice experiments, and testing of the MCDA framework against five clinical posterior restorative material options: dental amalgam, bulk-fill composite, glass ionomer cement, resin-modified glass ionomer, and zirconia-reinforced composite. Clinician preference surveys confirmed that clinical longevity (weight 0.31), cost to patient (0.28), ease of placement in non-ideal conditions (0.22), and environmental impact (0.19) were the four primary decision criteria. The MCDA framework produced context-specific material rankings that differed substantially from rankings in European and North American guidelines, reflecting the importance of cost and placement ease in Nigerian settings. Expert review by 16 dental materials and decision science specialists confirmed the methodology's original contribution. Recommendations include integration of the MCDA tool into Nigerian dental school curricula and NOHSS clinical guideline development processes.

Keywords: multi-criteria decision analysis, dental material selection, posterior restorative materials, Nigeria, decision framework