Contemporary endodontic practices among endodontic specialists in Saudi Arabia: a comparative cross-sectional study

This study aimed to assess and compare contemporary evidence-based endodontic practices and continuing education preferences among endodontists. A cross-sectional survey was conducted between November 2023 and January 2024 through in-person recruitment of endodontic residents and practicing endodontists from governmental and private sectors, as well as at a national dental conference. The questionnaire included 4 demographic items and 21 items evaluating clinical practices, satisfaction, and preferences for continuing education. Questions were presented in multiple-choice and Likert-scale formats. Descriptive statistics were calculated, and associations were examined using chi-square, Fisher’s exact and Kruskal-Wallis tests. Statistical significance was set at p < 0.05. A total of 115 endodontists met the inclusion criteria (residents: 30.4%, n = 35; specialists/consultants: 69.6%, n = 80). Most participants had fewer than 10 years of experience and worked in governmental institutions (78.3%, n = 90), although over half practiced in multiple settings. Cold testing and periapical radiographs were used universally. Sodium hypochlorite irrigation, electronic apex locators, and rotary instrumentation were used by nearly all respondents. Obturation was most commonly performed using warm vertical compaction and/or single-cone techniques (83.5%, n = 96). Calcium silicate-based sealers (93.9%, n = 108) and system-matched gutta-percha (97.4%, n = 112) were widely preferred. Cone beam computed tomography (CBCT) was used by 80% (n = 92), and consultants were more likely to request it routinely (p = 0.002). Consistent use of magnification and ethylenediaminetetraacetic acid (EDTA) solution was reported by 46.9% (n = 54) and 49.6% (n = 57), respectively. Satisfaction with instrumentation and obturation was moderate. Certification or fellowship programs were the preferred formats for continuing education. Endodontics residents, specialists and consultants reported strong adoption of several core evidence-based technologies. However, variation remains in routine CBCT use, magnification, and adjunctive EDTA irrigation. Structured continuing education programs were most preferred.