Perceived Stress and Psychological Distress in Prosthodontic Residents: A Systematic Review and Critical Appraisal of Evidence Gaps in Occupational Burnout.

Stress, psychological distress, and burnout are recognized occupational hazards in dentistry; however, the burden has not been synthesized separately for prosthodontics despite the specialty's distinctive combination of high-precision rehabilitation, prolonged treatment cycles, aesthetic expectations, laboratory dependency, and repeated adjustments. This systematic review followed PRISMA 2020 guidance and was prospectively registered in the PROSPERO database (CRD420261277566). The review had three objectives: (1) to synthesize perceived stress and psychological distress among prosthodontists and prosthodontic residents, (2) to determine whether validated instruments have been used to measure occupational burnout in this population, and (3) to appraise the methodological quality of the available evidence. Electronic searches were undertaken in PubMed, Scopus, Cochrane Library, LILACS, Google Scholar, and supplementary sources from inception to 10 January 2026. Additional searches included Shodhaganga, targeted web searches, and backward citation tracking. Three cross-sectional studies met the eligibility criteria. Two studies evaluated North American prosthodontic residents, and one evaluated postgraduate prosthodontic trainees in Saudi Arabia. Across studies, stress clustered around academic overload, faculty-related pressures, lack of time for personal life or leisure, inadequate support, and clinical or examination requirements. One North American study reported that more than one-third of residents exceeded the study-defined threshold for high stress, whereas a multicenter US study found that prosthodontics residents showed higher mean stress scores than pediatric dentistry and oral and maxillofacial surgery residents across multiple domains. Importantly, no eligible study used a validated burnout inventory; therefore, prosthodontics-specific burnout prevalence could not be estimated. JBI appraisal showed variable methodological quality, with concerns centering on confounding, sampling, and response rates. Current evidence, therefore, indicates elevated stress among prosthodontic residents, but a major evidence gap remains regarding occupational burnout measured using validated instruments.