Clinical applications and perceptions of bioceramics in endodontics: a cross-sectional survey

Bioceramic materials have emerged as a significant advancement in endodontics, offering excellent biocompatibility, sealing ability, and bioactivity.Their use has expanded in recent years, particularly for pulp capping, perforation repair, and regenerative procedures.

This study aimed to assess the knowledge of bioceramics among private practice dentists, evaluate the frequency of use of sealing and filling bioceramics, and examine the applied clinical protocols as well as potential shortcomings.

This cross-sectional study was conducted according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, based on an epidemiological Knowledge, Attitudes, and Practices (KAP) survey. It was carried out among Tunisian private practice dentists. Data were processed and analyzed using Excel 2007 and Statistical Package for the Social Sciences (SPSS) Statistics 21.0. The sample size was calculated using the standard formula for estimating a proportion in a cross-sectional study, and participants were randomly selected. Participation was voluntary, anonymous, and confidential.

A total of 200 dentists participated. Only 54.5% reported using sealing bioceramics, with 35.05% using them in all cases, 19.94% for periapical lesions, and 16.92% for root perforations. Approximately half of the dentists (53.01%) observed faster healing when using these sealers. Regarding filling bioceramics, 67.5% of participants used them, with a preference for MTA. These materials were indicated for various clinical situations, including repair of floor perforations, pulp capping, apexification of immature permanent teeth, and repair of root perforations. However, 45.61% of participants reported treatment failures when using these bioceramics, with failure to adhere to one of the endodontic treatment steps identified as the primary cause.

This study concluded that younger dentists tend to use bioceramics more frequently, filling bioceramics are better known than sealing ones, and most participants are familiar with the clinical indications of these materials. It is essential to provide further guidance and recommendations on the clinical application of bioceramics to optimize treatment outcomes.