## 4 Discussion
### Sustainability and Gender-Based Preferences  
Environmental sustainability emerged as a secondary, yet increasingly relevant, consideration among respondents in this study. According to our findings, dentists who are women more often consider biocompatibility when selecting materials, which suggests a gender-based preference for patient safety considerations. This attitude aligns with previous studies in which female practitioners are generally more responsive to environmental and health-related concerns in clinical settings [49; 80]. Despite this trend, only a limited proportion of respondents identified sustainability as a primary or high-priority factor in material selection. This finding aligns with observations that, although sustainability is gaining visibility in dental discourse, it is not yet fully integrated into routine decision-making [83]. Other studies have similarly highlighted the early stage of sustainability awareness in product marketing and procurement, where environmental considerations often remain secondary to technical performance, cost, and brand familiarity [26]. While recognition of environmentally responsible dentistry is growing among certain demographic groups, the incorporation of sustainable criteria into restorative material selection remains limited. The key challenge ahead is to translate awareness into action by embedding environmental performance within existing regulatory and quality standards [26; 80; 83]. As shown in previous research [27], awareness of sustainability in dental practice is growing, but its practical application in material selection is hindered by the lack of formal guidance and standardized environmental criteria. Similarly, the absence of dedicated eco-certification systems for dental products makes it challenging for practitioners to systematically assess the environmental impact of restorative materials [46]. So, although sustainability was acknowledged by some participants, our findings indicate that it is rarely translated into clinical decision-making or procurement practices. Future research and institutional policies could explore how environmental factors such as recyclability, carbon footprint, and material lifespan can be formally integrated into healthcare guidelines and procurement procedures. Embedding sustainability indicators into standard material selection frameworks could help dental practices align more closely with environmental and public health goals. Also in our study, ISO compliance remained the dominant criterion across all professional groups, though the underlying interest in sustainability suggests potential to align environmental goals with existing regulations. Recent perspectives suggest incorporating environmental performance metrics into standard procurement and quality assurance protocols [24]. This approach could embed sustainability into clinical workflows, enabling environmentally informed decisions without compromising safety or efficacy. Our findings reinforce this need, highlighting the importance of developing comprehensive, practice-relevant eco-standards that complement existing ISO regulations [84]. Further the prioritization of material features in this study also varied by gender and experience. Female dentists placed greater emphasis on biocompatibility, reflecting a stronger focus on patient safety and biological compatibility of materials. Conversely, less experienced clinicians prioritized mechanical properties, particularly bending strength, possibly reflecting a reliance on measurable, tangible criteria during early clinical practice. This divergence aligns with recent findings on gender-related patterns in dental education and career orientation [85]. Studies show that female dental students tend to prioritize patient-centered outcomes and long-term clinical effects, while male students focus more on technical aspects of care [86].