Knowledge, awareness, and clinical use of Bioceramic root canal sealers among endodontic practitioners and general dental practitioners in Saudi Arabia: a cross-sectional survey

The adoption of bioceramic root canal sealers (BRCS) has expanded considerably across global endodontic practice, driven by their advantageous biological and physicochemical properties, namely biocompatibility, hydrophilicity, dimensional stability, and alkaline pH. Nevertheless, there is a lack of research on the clinical application, awareness, and knowledge of these materials among general dental practitioners (GDPs) and endodontic practitioners (EPs) in Saudi Arabia. Therefore, we conducted this research to investigate this matter. The questionnaire comprises 17 items covering demographic characteristics, knowledge of BRCS, application practices, and motivations for BRCS use among study participants. The minimum required sample size was calculated using a 95% confidence level, a 5% margin of error, an expected BRCS-related knowledge prevalence of 50% (to yield the maximum required sample), and a finite-population correction ( N ≈ 983), giving a minimum required n of 277. A 17-item validated questionnaire was disseminated electronically to all Saudi Endodontic Society members in January 2026, with two reminders spaced 15 days apart. Statistical significance was set at P < 0.05. The survey was completed by 212 practitioners (21.7% response rate). Respondent demographics revealed a male predominance (66.5%), with the majority aged below 40 years (92%) and practicing in the central region (55.7%). The sample included 54.2% EPs and 45.8% GDPs. Of the 212 respondents, 204 (96.2%) had heard of BRCS. Among those who were aware of BRCS, 175/204 (85.8%) reported having used it clinically. Peer experience (42.9%) and conference attendance (31.0%) were the primary sources of information, while formal academic training accounted for less than 9% of knowledge acquisition. Single-cone obturation (SCO) emerged as the preferred technique when employing BRCS (46.3%), in contrast to the predominance of warm vertical compaction (WVC) with alternative sealers (45.6%). EPs demonstrated a significantly greater likelihood than GDPs to employ multiple obturation techniques with BRCS ( P = 0.003), inject sealers directly into the canal ( P = 0.017), and utilize non-pre-coated gutta-percha cones ( P = 0.001). The primary motivations for adopting BRCS were the superior biological and physicochemical properties (65%) and procedural efficiency (62%), which were significantly more important to endodontic practitioners than to GDPs ( P < 0.05). Among EPs and GDPs affiliated with the Saudi Endodontic Society, BRCS awareness and clinical use appear common, particularly among EPs. The present sample is not, however, representative of all Saudi dental practitioners; population-wide surveys of GDPs are needed before claims of nationwide adoption can be supported. However, the predominant reliance on informal learning pathways and persistent concerns regarding retreat ability underscore the necessity for enhanced BRCS-focused instruction within formal academic curricula.