Endodontic Practice Patterns Across Practitioner Profiles in France: A Cross-Sectional Survey

To compare clinical activity, technology adoption, and care delivery and to investigate contemporary endodontic practice in France across three predefined practitioner profiles: endodontic specialists (ES), endodontically oriented practitioners (EO), and general practitioners (GP).

A nationwide cross-sectional electronic survey was conducted in 2022 among French dentists listed by the Société Française d'Endodontie, with 1744 practitioners invited to participate. The questionnaire, adapted from a validated Australian survey, comprised 56 items covering demographics, work habits, use of technologies and materials, and perceptions of clinical activity. Reporting followed CROSS, CHERRIES, and STROBE guidelines. Practitioners were classified as ES, EO, or GP based on objective criteria: proportion of endodontic activity, referral patterns, and use of magnification. Descriptive statistics and between-group comparisons were performed using Chi-square tests or non-parametric methods when appropriate (α = 0.05).

A total of 452 responses were analysed (response rate 25.9%): 124 ES (27.5%), 122 EO (27.0%), and 206 GP (45.5%). Significant intergroup differences were observed in training, workload, access to care, and clinical protocols (p < 0.001). ES reported the highest adoption of magnification, cone-beam computed tomography (CBCT), rubber dam isolation, rotary glide-path preparation, chelating agents, warm obturation techniques, and bioceramic materials. EO demonstrated intermediate but increasingly specialist-aligned practices, whereas GP showed greater heterogeneity and lower uptake of advanced technologies. Across all groups, perceived failure rates were low; tooth fracture and restorability issues were the main reasons for tooth loss rather than endodontic failure.

Comparison across three predefined practitioner profiles highlights distinct patterns of clinical activity, technology adoption, and care delivery in French endodontic practice. Although practitioner profiles were defined a priori, the observed differences in clinical activity, technology use, and referral patterns support the clinical relevance and internal coherence of this classification. EO emerge as a pivotal intermediate group bridging general practice and specialist care and contribute substantially to the management of complex cases. These findings support the relevance of this tiered practitioner framework and argue for structured training pathways and improved referral coordination to optimise access to high-quality endodontic care.