Knowledge, Awareness, and Clinical Practice of Digital Technologies in Endodontics among Dental Professionals in Southern Saudi Arabia: Cross-sectional Survey Study

Aim: This study aimed to assess the knowledge, awareness, and clinical utilization of digital endodontic technologies among dental professionals in southern Saudi Arabia (SA) and compare patterns of adoption between specialists and general practitioners, including interns.Methodology: A descriptive cross-sectional survey was conducted between April and July 2025 using a validated, self-administered online questionnaire distributed through professional and academic networks to 300 dental professionals from academic, governmental, and private sectors in southern SA.The questionnaire comprised 22 closed-ended items organized into four sections: Demographic and professional characteristics (four items), knowledge of digital technologies (seven items), awareness and perceptions (seven items), and clinical utilization (four items).Data were analyzed using descriptive statistics and Pearson's Chi-square test to determine associations between professional category and adoption of digital tools, with a significance level set at p < 0.05.Results: A total of 222 valid responses were obtained (response rate = 74%), including 87 specialists (39.2%) and 135 general practitioners (60.8%), comprising 78 licensed dentists and 57 interns.Overall, 174 participants (78.4%) were familiar with digital endodontics.The most recognized tools were digital radiography (49; 22.1%), cone-beam computed tomography (CBCT) (43; 19.4%), and electronic apex locators (EALs) (43; 19.4%), whereas awareness of guided endodontics (30; 13.5%), 3D printing (15; 6.8%), and artificial intelligence (AI)-assisted diagnosis (14; 6.3%) remained limited.Electronic apex locators (68; 30.6%) and nickel-titanium (NiTi) rotary files (140; 63.1%) were the most frequently used, while guided endodontics (38; 17.1%) and AI-assisted diagnosis (3; 1.4%) showed minimal clinical integration.Specialists exhibited significantly greater knowledge and utilization of advanced tools than general practitioners (p < 0.05).Key barriers included high equipment cost (121; 54.5%), inadequate training (44; 19.8%), and limited availability (34; 15.3%).Although 165 participants (74.3%) considered digital technologies essential for the future of endodontics, only 59 (26.6%) reported undergraduate exposure, highlighting substantial educational gaps.Conclusion: Digital endodontic integration in southern SA is advancing but remains uneven.Foundational tools are widely adopted, whereas advanced technologies are largely confined to specialist and academic settings.Limited undergraduate training, specialization, and infrastructural disparities are key determinants of this uneven adoption.Clinical significance: Bridging the awareness-practice gap requires curriculum enhancement, continuing professional development, and equitable access to digital infrastructure to support evidence-based and technologically competent endodontic practice.