Survey on endodontists’ preferences and perceptions of root-end filling materials: A comparative analysis of calcium silicate-based cement-KAPP survey

ABSTRACT Aim: This survey was conducted to evaluate the knowledge, attitudes, clinical practices, and perceptions of endodontists in relation to the choice of root-end filling materials. Methods: A 16-question online survey, validated by a senior academic endodontist, was distributed among the Indian Association of Conservative Dentistry and Endodontics and the Indian Endodontic Society members. The questionnaire included the choice of material, its properties, and techniques. Results: Among 219 endodontists (60% response rate), 91.3% preferred calcium silicate (CS) as a root-end filling material, with mineral trioxide aggregate (MTA) being the top choice (52.5%). Biodentine was rated best for handling (50.2%). CS was the most radiopaque (66.7%), tissue-friendly (89.2%), successful (92.2%), and compactable with high displacement resistance (72.6%) and sealing ability (82.9%). Over half (58%) ranked setting time as Biodentine < EndoSequence root repair material < BioAggregate < MTA. MTA was considered the most antimicrobial (81.2%) and cost-effective (59.8%). Endodontists with academic affiliations preferred Biodentine over private practitioners for handling ( P = 0.04). Those with both academic and clinical backgrounds rated CS slightly less than other groups for radiopacity ( P = 0.01). Regardless of experience, CS was favored for tissue-friendliness ( P = 0.01), minimal microleakage, and sealing ability ( P = 0.05). Experienced respondents preferred intermediate restorative material (IRM) over CS for radiopacity ( P = 0.003), ease of compaction, and resistance to displacement ( P = 0.001). Older respondents favored IRM over CS for radiopacity ( P = 0.03), resistance to displacement, and ease of compaction ( P = 0.03). All respondents, regardless of age, preferred CS ( P = 0.05). Conclusion: CS is the preferred root-end filling material. While knowledge, attitude, practice, and perception are generally adequate, awareness is needed in areas such as radiopacity and compaction.