Patterns of Endodontic Practice and Technological Uptake Across Training Levels in Spain and Latin America: Results from a Multicountry Survey of 1358 Clinicians

<b>Background/Objectives</b>: The objective of this study was to investigate current endodontic practice patterns and the adoption of newer technologies among dentists, endodontic specialists, and postgraduate students in Spain and Latin America. <b>Methods:</b> A cross-sectional survey was conducted using a structured 30-item questionnaire covering demographics, training, technology adoption (NiTi instrumentation, magnification, CBCT, irrigation adjuncts, bioceramic sealers), obturation techniques, irrigant selection, and clinical procedures. The survey was distributed through a professional Instagram account and WhatsApp groups of dentists, specialists, and postgraduate students. Participation was voluntary, anonymous, and restricted to qualified professionals. Data were collected via Google Forms, cleaned, and grouped into Spain, Mexico, Venezuela, Colombia, Southern Cone & Andes (Argentina, Chile, Peru, Ecuador, Bolivia), and other countries. Descriptive statistics were calculated, and intergroup comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction (<i>p</i> < 0.05). Multiple regression analyses were performed. <b>Results:</b> A total of 1358 valid responses were analyzed, distributed as follows: Spain (219), Mexico (353), Venezuela (162), Colombia (108), Southern Cone & Andes (260), and other countries (256). Most respondents (62.8%) had ≤10 years of experience, and 61.2% reported postgraduate training. Loupes (55.4%) were the most frequent magnification system, followed by microscopes (18.6%). Sodium hypochlorite (98.3%) was the irrigant of choice, commonly used with EDTA (83.5%) and, to a lesser extent, chlorhexidine (33.4%). Sonic (83.2%) and ultrasonic (52.9%) activation were frequent. Bioceramic sealers were used by 18.9%, while calcium hydroxide medication was applied by 37.4%. Specialists and master-level clinicians showed greater use of rotary NiTi systems, CBCT, magnification, and bioceramic sealers, whereas general practitioners relied more on manual instrumentation and single-cone obturation. Success was mainly verified by combined clinical and radiographic evaluation (86.7%). Spain demonstrated higher adoption of microscopes, warm vertical compaction, and CBCT. <b>Conclusions:</b> Core practices such as sodium hypochlorite irrigation and rubber dam use were widespread, while advanced technologies and irrigant protocols varied with training level and region. Continuous education remains essential to promote evidence-based practice and reduce disparities in endodontic innovation.