Randomization and consultations
teeth or implants).
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Seventy-five patients were thus included and randomly assigned to three equal-sized groups of 25 patients, each defined by a slightly different approach to prosthodontic consultation. All three approaches had in common that the patient went through a dialog with a defined clinician in a defined room based on the findings of a clinical intraoral examination and on the radiographic records (see above).All conversations were conducted by the same clinician in the same room. As particularly short or long clinical experience was not considered desirable, a clinician with a medium experience level of 5 years was selected. No calibration took place, but group bias by learning effects was avoided by cycling through the three groups in the same order. Care was taken in the conversations to discuss the pros and cons of different treatment options, placing a strong focus on the patient’s own views to arrive at treatment decisions meeting the criteria of “shared decision-making.” More specifically, the same four steps of communication were followed as outlined in the Introduction [Paper-based PDA (left) and software-based PDA (right) 
Control group (no PDA). In this group, the clinician did not use any aids other than the existing radiographs and the intraoral findings on a sheet of paper in explaining treatment options to the patients for shared decision-making.Test group 1 (paper-based PDA). In this group, the clinician adopted the same approach as in the control group but additionally used a loose-leaf publication for patient information that comes in a cardboard box (DemoBox dental; Spitta, Balingen, Germany). Hence, the alternative options were both explained orally and demonstrated to the patient via paper-based illustrations of conservative, periodontal, and prosthodontic treatment. With this PDA, selective information could be provided depending on the number of missing teeth (single spaces, multiple spaces, or edentulism in anterior or posterior segments) for different prostheses (fixed, removable, or combined) and abutments (teeth or implants). Pros and cons of the alternative options could also be illustrated using this PDA.Test group 2 (software-based PDA). In this group, the clinician adopted the same approach as in the control group but additionally used a software-based library for patient information (Dental Explorer 3D; Quintessence Publishing, Berlin, Germany) to support the conversation. In this way, specific aspects of the case were visualized on a computer screen. This PDA includes not only images but also three-dimensional models and video sequences illustrating a variety of prosthetic designs. It can also be used to create digital casts for the case-specific situation to be visualized, so that alternative options of treatment could be demonstrated and their expected outcomes previewed together with the patient.A schematic roadmap to the study is provided in Fig. Schematic roadmap to the study