Knowledge, attitudes, and perceived barriers toward guided endodontic access among dental practitioners in Saudi Arabia: a cross-sectional study

Background Guided endodontic access (GEA) is an emerging digital technique that integrates cone-beam computed tomography (CBCT) with three-dimensional printing to enable precise and conservative access cavity preparation. It enhances canal localization and reduces procedural errors, particularly in cases with pulp canal calcification or complex root canal anatomy. Despite these advantages, its clinical adoption remains limited. This study aimed to assess the knowledge, attitudes, and perceived barriers toward GEA among dental practitioners in Saudi Arabia and to examine factors influencing its adoption. Methods A cross-sectional survey was conducted among dental practitioners actively engaged in clinical practice in Saudi Arabia. Data were collected using a structured, validated electronic questionnaire distributed via professional dental networks. The questionnaire assessed demographic characteristics, awareness and training in GEA, perceived clinical benefits, and barriers to implementation. Descriptive statistics were used to summarize responses, and chi-square tests were applied to evaluate associations between practitioner characteristics and GEA-related knowledge, attitudes, and adoption patterns. Statistical significance was set at p < 0.05. Results A total of 401 dental practitioners participated in the study. Most respondents (85.5%) reported prior awareness of GEA, and 78.8% indicated having received formal training. Participants demonstrated generally positive attitudes toward GEA, with most agreeing that it improves procedural accuracy, enhances safety, and facilitates management of complex endodontic cases. However, barriers to implementation included high cost, increased procedural time, and the need for specialized training and equipment. Significant associations were observed between GEA knowledge and adoption and practitioners’ gender, clinical experience, and academic qualifications. Conclusions Dental practitioners in Saudi Arabia demonstrate high awareness and favorable perceptions of GEA; however, practical barriers continue to limit its widespread adoption. Addressing cost limitations, expanding training opportunities, and integrating digital workflows into dental education may facilitate broader clinical implementation.