Reliability and Accuracy of YouTube Peri-Implantitis Videos as an Educational Source for Patients in Population-Based Prevention Strategies

Considering the need to improve patient knowledge, awareness, and compliance for peri-implantitis prevention, and patients’ demand for better, quick, and convenient access to medical information, the present study primarily assessed the reliability and accuracy of YouTube videos on peri-implantitis and secondarily evaluated their educational value for the patients, and the related suitability, as part of population-based preventive strategies, to deliver valid information, potentially capable of improving patient knowledge and educational skills. This study’s protocol was developed in advance, and computer history and cookies were cleared to avoid limitations based on preferred user histories. The search term “peri-implantitis” was defined using the Google Trends website, and videos were searched on YouTube on 5 December 2022. Video inclusion and data collection were conducted by independent pre-calibrated investigators. Descriptive statistics were performed on the videos’ characteristics, source, category, target audience, popularity, source reliability, video information and quality (VIQI), content, and educational value. Pearson’s correlation between educational value and all parameters was calculated. Videos with very low/low and medium/good/excellent educational value were compared using the Mann–Whitney U test. A total of 44 videos with medium values for popularity, VIQI, content, and educational value were analyzed. Most videos covered peri-implantitis treatment rather than etiology and prevention, about half were uploaded by dentists/specialists, and only 10% specifically targeted patients. Only 2% of YouTube videos about peri-implantitis had excellent educational value, and 5% had good educational value. Video educational value was correlated with VIQI and content beyond video length and source reliability. When comparing the very low/low and medium/good/excellent educational value YouTube videos on peri-implantitis, a significant difference was found in the Video Information and Quality Index, VIQI, and video content.


Introduction
Peri-implantitis is a destructive inflammatory process that affects the tissues surrounding dental implants and is characterized by mucosal inflammation and bone loss [1,2].
The prevalence of peri-implantitis ranges from 1% to 85% when considered at the patient rather than implant level [3], and the incidence rate increases from approximately 0.5% to 40% within 3 to 5 years after implant placement [3]. Periodontitis, smoking, and a lack of preventive interventions are currently recognized as risk factors for periimplantitis [4], as are diabetes mellitus [4] and poor oral hygiene [5], whereas age, gender,

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -Video quality: ≥240p.

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study: puter history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  Characteristics: link, length of video (minutes); number of views; number of likes; number of dislikes; number of comments; number of subscriptions; time elapsed since upload.  Source: classified as dentist/specialist; hospital/university/scientific dental associations; commercial; other.  Category: education; people and blogs; science and technology; film and animation; others.  Target audience: classified as laypersons; professional; both.  Video Power Index (VPI) [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Characteristics: link, length of video (minutes); number of views; number of likes; number of dislikes; number of comments; number of subscriptions; time elapsed since upload.
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  Characteristics: link, length of video (minutes); number of views; number of likes; number of dislikes; number of comments; number of subscriptions; time elapsed since upload.  Source: classified as dentist/specialist; hospital/university/scientific dental associations; commercial; other.  Category: education; people and blogs; science and technology; film and animation; others.  Target audience: classified as laypersons; professional; both.  Video Power Index (VPI) [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Source: classified as dentist/specialist; hospital/university/scientific dental associations; commercial; other.

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Category: education; people and blogs; science and technology; film and animation; others.

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Target audience: classified as laypersons; professional; both.

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Video Power Index (VPI) [9,21].

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Video Information and Quality Index (VIQI) [21].

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Video content [22].

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  Characteristics: link, length of video (minutes); number of views; number of likes; number of dislikes; number of comments; number of subscriptions; time elapsed since upload.  Source: classified as dentist/specialist; hospital/university/scientific dental associations; commercial; other.  Category: education; people and blogs; science and technology; film and animation; others.  Target audience: classified as laypersons; professional; both.  Video Power Index (VPI) [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Video source reliability [34].

Study Design
The present cross-sectional evaluation of Internet-based video media did not require approval from the Local Research Ethics Committee, as it contains only public data.
This study's protocol was developed before the search. Before searching, the computer history and cookies were deleted to prevent restrictions based on preferential user history.

Search Strategy
YouTube (freely available at http://www.youtube.com) (accessed on 5 December 2022) was searched for relevant videos uploaded until 5 December 2022. The search keywords "peri-implantitis treatment" were defined through the Google Trends Web site (freely available at https://trends.google.com/trends/), with "worldwide" and "last 5 years" settings, and no related queries available. The filters applied to the YouTube search were the following: video duration between 4 and 20 min, ranking based on the "level of relevance".
Since previous studies have shown that 80-90% [14] of the search results may change on different days, all the videos' source locations (URL) were backed up and recorded.

Eligibility Criteria
Two independent investigators (M.P.D.P., D.C.) with experience in oral medicine and oral surgery independently screened eligible videos. Multipart videos were considered single videos.
The inclusion criteria were as follows: -Video quality: ≥240p.

Data Collection
The calibration of 10 videos randomly chosen was performed by three investigators (F.G., M.O., N.C.) with experience in oral medicine and oral surgery.
The following data were independently extracted, computed, and collected by the two investigators (M.O., N.C.) involved in the pre-calibration on a standardized extraction form for each video included in the present study:  Characteristics: link, length of video (minutes); number of views; number of likes; number of dislikes; number of comments; number of subscriptions; time elapsed since upload.  Source: classified as dentist/specialist; hospital/university/scientific dental associations; commercial; other.  Category: education; people and blogs; science and technology; film and animation; others.  Target audience: classified as laypersons; professional; both.  Video Power Index (VPI) [9,21].  Video Information and Quality Index (VIQI) [21].  Video content [22].  Video source reliability [34]. Video educational value (GQS) [22,35,36].

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria: Video educational value (GQS) [22,35,36].

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.  Score 4 = Good quality and flow, most important topics covered; useful to patients.  Score 5 = Excellent quality and flow; highly useful to patients.
Videos rated <3 were classified as having very low/low educational value, and those rated ≥3 as having medium/good/excellent educational value for patients' education, as part of population-based preventive strategies.
"Flow of the information.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).
 Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.
 Score 4 = Good quality and flow, most important topics covered; useful to patients.  Score 5 = Excellent quality and flow; highly useful to patients. Videos rated <3 were classified as having very low/low educational value, and those rated ≥3 as having medium/good/excellent educational value for patients' education, as part of population-based preventive strategies.
Accuracy of the information.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.  Score 4 = Good quality and flow, most important topics covered; useful to patients.  Score 5 = Excellent quality and flow; highly useful to patients.
Videos rated <3 were classified as having very low/low educational value, and those rated ≥3 as having medium/good/excellent educational value for patients' education, as part of population-based preventive strategies.
Quality (use of photographs, animation, reports from members of the public, video headings, and summary).

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).
 Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.
 Score 4 = Good quality and flow, most important topics covered; useful to patients.  Score 5 = Excellent quality and flow; highly useful to patients. Videos rated <3 were classified as having very low/low educational value, and those rated ≥3 as having medium/good/excellent educational value for patients' education, as part of population-based preventive strategies.
Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.  Score 4 = Good quality and flow, most important topics covered; useful to patients.  Score 5 = Excellent quality and flow; highly useful to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).
 Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.
 Score 4 = Good quality and flow, most important topics covered; useful to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients.  Score 3 = Suboptimal flow, some information covered but important topics missing; Prevention.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:  Score 1 = Poor quality; very unlikely to be of any use to patients.  Score 2 = Poor quality but some information present; of very limited use to patients. Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34] Healthcare 2023, 11

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)  Currency (dates that content was posted and updated should be indicated)".

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrange-relevant copyright information reported)

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided)  Attribution (references and sources for all content should be listed clearly, and all  relevant copyright information reported)  Disclosure (website "ownership" should be prominently and fully disclosed, as Disclosure (website "ownership" should be prominently and fully disclosed, as should any sponsorship, advertising, underwriting, commercial funding arrangements or support, or potential conflicts of interest)

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology.  Diagnosis.  Prevention.  Treatment (any).

Video Source Reliability
The reliability of the source of the medical information retrieved through videos was determined using four criteria, known as the Journal of American Medical Association (JAMA) benchmark criteria, suggested by Silberg et al. [33,34]  "Authorship (authors and contributors, their affiliations, and relevant credentials should be provided) Currency (dates that content was posted and updated should be indicated)".

Video Educational Value
The videos' educational value was rated based on the five-point Global Quality Scale (GQS) criteria [22,35,36]:

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any).

Video Source Reliability
Score 1 = Poor quality; very unlikely to be of any use to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any). Score 2 = Poor quality but some information present; of very limited use to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).
 Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Treatment (any). Score 3 = Suboptimal flow, some information covered but important topics missing; somewhat useful to patients.

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:

Video Power Index
The Video Power Index, assessing video popularity, was computed as follows: Like ratio (Number of likes + Number of dislikes/Number of views × 100) × View ratio (Number of views/Number of days since the video was uploaded × 100)/100 [9,16,21].

Video Information and Quality Assessment
The video information and quality index (VIQI) examined the videos' general quality, scoring 1-20 [35].
A five-point Likert-type scale (from 1 = low quality to 5 = high quality) was employed to evaluate each of the following criteria:  "Flow of the information.  Accuracy of the information.  Quality (use of photographs, animation, reports from members of the public, video headings, and summary).  Sensitivity (the consistency level between the video title and the content)".

Video Content Assessment
The content of the videos was evaluated, providing a total content score of 1-5, according to the coverage of the following topics:  Definition/diagnostic criteria.  Etiology. Score 5 = Excellent quality and flow; highly useful to patients.
Videos rated <3 were classified as having very low/low educational value, and those rated ≥3 as having medium/good/excellent educational value for patients' education, as part of population-based preventive strategies.

Statistical Analysis
The normality of the data distribution was determined through the Shapiro-Wilk test (p value < 0.001). The descriptive statistical analysis was performed for all of the YouTube videos included. The correlation between the educational value and videos' characteristics, popularity, Information and Quality Index (VIQI), content topics and score, and the video source reliability was computed through Pearson's correlation test.
The included videos were categorized based on the educational values as very low/low (<3) and medium/good/excellent (≥3) educational value videos, analyzed, and compared with the Mann-Whitney U-test.

YouTube Videos on Peri-Implantitis: Inclusion and Data Collection
Out of the 120 videos initially retrieved, a total of 44 YouTube videos on peri-implantitis compliant with the eligibility criteria were considered in the present study, mainly due to the inconsistency between the title and content and the lack of information provided on peri-implantitis.
Related data extracted, computed, and collected are available as a Supplementary Materials.

YouTube Videos on Peri-Implantitis: Descriptive Analysis
The median length of the videos was 5.58 (4.02-19.3) mins. The videos were uploaded between 27 and 2842 days (median time elapsed since upload 974) before the search and received a median number of views of 684, with a median number of likes of 6.5 (0-333), no dislikes, and a Video Power Index VPI of 1.09.
The median Video Information and Quality Index VIQI (0-20 score) was 12.0. The median video educational value (0-5 score) was 2.0; thus, on average, the videos included were considered to be of low to medium educational value.
The included videos' length, number of views, likes, dislikes, comments and subscriptions, the time elapsed since upload, the Video Power Index (VPI), the video source reliability, the Video Information and Quality Index (VIQI), the video content, and the video educational value (GQS) are detailed in Tables 1 and 2.  Table 2. YouTube videos on peri-implantitis: Video Power Index "VPI"; Video Information and Quality Index "VIQI" (1-20 total score); video content on peri-implantitis (1-5 total score); video source reliability based on JAMA benchmark (0-4 total score); video educational value (0-5 total score). The median video source reliability (0-4 score) was 2.5 and dentists/specialists uploaded 53.2% of the videos. Approximately 40% of the videos fell into the "education" category. About 10.6% of the videos were produced for laypersons.

Median
The source, category, and target audience of YouTube videos on peri-implantitis are shown in Figures 1-3. Healthcare 2023, 11, x FOR PEER REVIEW 6 of Video educational value (0-5 score) 2.00 4 1.00 5.00 The median video source reliability (0-4 score) was 2.5 and dentists/specialists up loaded 53.2% of the videos. Approximately 40% of the videos fell into the "education category. About 10.6% of the videos were produced for laypersons.
The source, category, and target audience of YouTube videos on peri-implantitis ar shown in Figures 1-3.   The median video content score (1-5 score) was 2, indicating that, on averag YouTube videos covered at least two of the five relevant topics (definition/diagnostic cr teria, etiology, diagnosis, prevention, treatment).
The content topics of the videos are shown in Figure 4.   The median video content score (1-5 score) was 2, indicating that, on average, YouTube videos covered at least two of the five relevant topics (definition/diagnostic criteria, etiology, diagnosis, prevention, treatment).
The content topics of the videos are shown in Figure 4.  The educational value of the videos assessed using the five-point Global Quality Scal (GQS) criteria was distributed as follows: 7% of the videos had very low and 43% low value, whereas medium, good and excellent value was assigned to 34%, 11%, and 5% o the videos analyzed, respectively.

YouTube Videos on Peri-Implantitis: Correlation between Video Educational Value and Other Parameters
Pearson's correlation coefficients measuring the strength of the linear association be tween the videos' educational value and the videos' characteristics of popularity (VPI general quality (VIQI), content, and source reliability are listed in Table 3.
Video educational value was significantly related to the length of the video (r = 0.353 p-value = 0.016), the number of likes (r = 0.386, p-value = 0.008) and video source reliabilit (r = 0.314, p-value = 0.034), but not specifically related to the uploading dentist/specialis (r = 0.153, p-value = 0.311).
A highly significant correlation was found among the video educational value, th Video Information and Quality Index (r = 0.714, p-value < 0.001) and the video conten score (r = 0.670, p-value < 0.001); specifically, the video educational value was significantl correlated with the "Definition/Diagnostic criteria" (r = 0.437, p-value < 0.002) and the "D agnosis" (r = 0.529, p-value < 0.001) content topics, but not with "Prevention" and "Etio ogy", nor with "Treatment" ones.  The educational value of the videos assessed using the five-point Global Quality Scale (GQS) criteria was distributed as follows: 7% of the videos had very low and 43% low value, whereas medium, good and excellent value was assigned to 34%, 11%, and 5% of the videos analyzed, respectively.

YouTube Videos on Peri-Implantitis: Correlation between Video Educational Value and Other Parameters
Pearson's correlation coefficients measuring the strength of the linear association between the videos' educational value and the videos' characteristics of popularity (VPI), general quality (VIQI), content, and source reliability are listed in Table 3. Table 3. Correlation between the videos' educational value and the videos' characteristics, popularity (VPI), general quality (VIQI), content score and domains, source reliability, and dentist/specialist source was computed using Pearson's correlation test. Video educational value was significantly related to the length of the video (r = 0.353, p-value = 0.016), the number of likes (r = 0.386, p-value = 0.008) and video source reliability (r = 0.314, p-value = 0.034), but not specifically related to the uploading dentist/specialist (r = 0.153, p-value = 0.311).
A highly significant correlation was found among the video educational value, the Video Information and Quality Index (r = 0.714, p-value < 0.001) and the video content score (r = 0.670, p-value < 0.001); specifically, the video educational value was significantly correlated with the "Definition/Diagnostic criteria" (r = 0.437, p-value < 0.002) and the "Diagnosis" (r = 0.529, p-value < 0.001) content topics, but not with "Prevention" and "Etiology", nor with "Treatment" ones.

YouTube Videos on Peri-Implantitis: Comparison between Very Low/Low and Medium/Good/Excellent Educational Value Videos
A total of 22 YouTube videos on peri-implantitis were rated <3 and classified as having very low/low educational value, and the remaining 22 were rated ≥3 and classified as having medium/good/excellent educational value, based on the five-point Global Quality Scale (GQS).
Variables of very low/low and medium/good/excellent educational value videos are reported in Table 4. When comparing the very low/low and medium/good/excellent educational value YouTube videos on peri-implantitis, a significant difference was found in the Video Information and Quality Index (p-value < 0.001) and video content (p-value < 0.001).
The comparison of variables between very low/low and medium/good/excellent educational value videos computed with the Mann-Whitney U test is shown in Table 5.

YouTube Videos on Peri-Implantitis: Reliability and Accuracy
A total of 44 YouTube videos on peri-implantitis were included in the present crosssectional analysis of educational reliability and accuracy to improve patient knowledge, awareness, and compliance as a population-based prevention strategy (Table 1). Compared with the 120 videos initially found in the search, this reduced number of videos analyzed was mainly due to inconsistencies between the title and the content, and the lack of information provided on peri-implantitis. Limiting the videos' length to 4-20 min certainly reduced the number of search results, but based on the suggested optimal video duration to maintain viewer attention, ranging from 5-6 [37,38] to 10 min [37,38], indirectly increased the likelihood that YouTube videos were viewed in their entirety, making the presented results generalizable, particularly with regard to population-based prevention strategies, although the median length of the 44 videos was 5.58 min. However, data on viewing duration could not be retrieved from YouTube.
The total number of views of the videos analyzed varied widely (median = 684.00) ( Table 2), suggesting a limited distribution of the videos.
The popularity of the videos, although no dislikes were recorded, was even more modest, with a median number of likes of 6.50 and a median Video Power Index of 1.09 (Table 2), suggesting the videos' low appeal. In any case, it should be noted that the time elapsed from video upload ranged from 27 days to approximately 6 years (Table 2), with a median of 974 days (about 3 years), revealing a relatively recent introduction of peri-implantitis content to YouTube.
Less than half (40.4%) of the YouTube videos on peri-implantitis were in the "education" category ( Figure 3), and only 10.6% were directed at laypersons (Figure 2), indicating that most of the videos were probably not uploaded for educational purposes for patients. Accordingly, the median video content score (1-5 score) was 2.0 (Table 1), indicating that these YouTube videos, on average, covered at least two of the five topics examined (definition/diagnostic criteria, etiology, diagnosis, prevention, treatment), and thus offered to patients incomplete information about peri-implantitis, even when considering multi-part videos as a whole.
Moreover, the most frequently covered content was the treatment of peri-implantitis (88.63%), followed by definition/diagnostic criteria (47.72%), and less so by etiology (36.33%) and prevention (31.81%) (Figure 4), which is critical for patient knowledge and awareness regarding the control of peri-implantitis risk factors.
Furthermore, 53.2% of the videos were uploaded by dentists/specialists, while only 6.4% were uploaded by recognized institutions, such as universities or hospitals (Figure 1), with a median video source reliability (0-4 score) of 2.50 (Table 1). Notably, YouTube videos on peri-implantitis were the least likely to meet the "disclosure" criterion, similar to peri-implantitis websites [39].
Monje et al. [32] advocated the use of visual aids in combination with essential and clearly presented information to better inform patients and induce positive behavior changes. YouTube, as an online video-sharing and social media platform, can overcome the critical problem of search engines such as Google ® and Yahoo! ® by providing easier-to-understand visual content to improve patient knowledge and awareness of population-based prevention strategies, potentially playing a key role in conveying medical and dental information to patients and improving their understanding [39]. Conversely, patient-oriented online information about peri-implantitis on Internet websites, particularly Google ® and Yahoo! ® [39], was found to be challenging to understand due to complex and technical terminology and, consequently, of limited use for patient education. However, the median Video Information and Quality Index (0-20 score) was 12.00 (Table 1), reflecting how the flow and accuracy of the information, the consistency between the video title and content, previously discussed, and overall video quality (video headlines, summary, photos, animations, etc.) were generally moderate.

YouTube Videos on Peri-Implantitis: Educational Value
Unfortunately, half of the YouTube videos on peri-implantitis were of very low/low educational value (GQS < 3), and the other half were of medium/good/excellent educational value (GQS ≥ 3); specifically, 34.09% of the videos had a medium educational value, and only 11.36% and 4.54% had a good and excellent educational value, respectively. Thus, the majority of the YouTube videos on peri-implantitis analyzed were rated as poor for patient education.
These results are consistent with those of YouTube videos on other medical and dental content. Indeed, the information quality of YouTube videos on orthopedics [9] and allergology/immunology [40] has been rated as inadequate or misleading. Studies on the reliability of YouTube videos on the rehabilitation of complete dental arches with dental implants [16], endodontic treatment [41], and burning mouth syndrome [19] also reached similar conclusions. In contrast, two-thirds of YouTube videos on type 2 diabetes [42] [ Leong, 2017] and more than half of the videos on Sjogren's syndrome [20] were found to be educationally valid, with a good or excellent global quality rating.
Similar to the results reported by Lena et al. [15], who analyzed YouTube videos on lingual orthodontic treatment, the educational value of peri-implantitis videos was significantly related to video length (r = 0.353, p-value = 0.016) ( Table 3), suggesting that conveying accurate and complete information requires appropriate time, as previously described [37,38]. However, when comparing duration, no statistical difference was found between high-and low-educational value videos on peri-implantitis (Table 5) as well as on stainless steel crowns [21].
In previous studies, videos with low information and quality and low educational value (low VIQI and GQS) were often more popular and preferred among YouTube users, probably because they were easier to understand for people without a medical background [9,19]. In contrast, in the present study, the educational value of the videos was significantly related to the number of likes (r = 0.386, p-value = 0.008) ( Table 3). This is likely due to the fact that most YouTube videos about peri-implantitis targeted a professional audience (44.7%) (Figure 3), who find videos with high-quality and medium/good/excellent educational value the most useful to enrich their cultural background.
Although videos produced by healthcare professionals or institutions were found to be of greater educational value [43], a nonsignificant association was found between the uploaders and the educational value (Table 3). Conversely, as expected, the educational value of the videos was significantly associated with video source reliability (r = 0.314, p-value = 0.034) ( Table 3).
When comparing YouTube videos on peri-implantitis with very low/low and medium/ good/excellent educational value, a significant difference was found in the Video Information and Quality Index (p-value < 0.001) and video content score (p-value < 0.001) ( Table 5), possibly illustrating how closely the accuracy and completeness of the information provided is related to its ability to convey valid information potentially capable of improving the patients' knowledge and educational skills.
The main limitations of the present cross-sectional analysis of the reliability and accuracy of YouTube videos in improving patient knowledge, awareness, and compliance may be ascribable to the dynamic nature of the platform, where videos are uploaded and deleted daily, and the restriction of the language of the videos to English, considering that other languages, especially Chinese, Hindi, and Spanish, are even more widely used (data available free online at: https://en.wikipedia.org/wiki/List_of_languages_by_total_ number_of_speakers) (accessed on 5 December 2022).
However, the present study may be the first to examine the popularity, information and quality, content, and source of YouTube videos on peri-implantitis and to evaluate the associated content accuracy, source reliability, and educational value. In addition, the results presented were compared with those of a recent study assessing the intelligibility of educational content on peri-implantitis websites to comprehensively assess the suitability of available patient-centered Internet information for population-based peri-implantitis prevention strategies [44].
Further cross-sectional analyzes should be conducted without language restrictions, including other social media platforms, and should be continuously updated. Indeed, dentists should be aware of the information available on the Internet and refer patients to appropriate sources with accurate and up-to-date content to improve the suitability of YouTube videos as an educational resource for patients in population-based prevention strategies against peri-implantitis.
Future studies of patient-centered, educational Internet information for peri-implantitis prevention should evaluate not only the accuracy of the information, but also its impact on patient knowledge, awareness, and compliance, as well as methods that are more engaging and effective for patients [45]. A pool of good/excellent educational videos on YouTube aimed at the general population and focusing primarily on recognized modifiable, particularly behavioral, risk factors associated with peri-implantitis and the benefits of preventive measures could be specifically developed.
In addition to videos aimed at a professional audience [46], patient-centered videos can be developed. They should be short (no longer than 10-15 min) in order to retain the viewers' attention, have a cartoon-like design in order to be attractive, and present precise and synthetic information clearly, in order to avoid fatigue and distraction, in simple and essential language combined with visual aids to achieve better understanding [38,47].

Conclusions
Less than half of the YouTube videos on peri-implantitis fell into the "education" category, and the language used was often technical and difficult for patients to understand, making it unlikely that they were uploaded for patient education purposes. The educational value of the videos was mostly rated as poor and was significantly related to video length, source reliability, the Video Information and Quality Index, and video content.
Most of the videos covered the treatment of peri-implantitis rather than its prevention and etiology, which are critical for patient knowledge.
Supplementary Materials: The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/healthcare11142094/s1, Table S1: Data extracted and computed from the videos included.