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Background  To establish the extent of using nickel titanium rotary instruments (NiTi-RIs), to identify reasons for using / not using NiTi-RIs, to explore usage modalities and to identify factors and measures that can increase implementation of NiTi-RIs in general dental practice.    Methods  Two pilot questionnaires were conducted on academic staff members at College of Dentistry, Taibah University, general dentists (GDs) and endodontists to finalise the questionnaire. A sample size was calculated considering the expected and minimum accepted response rates (60 and 48%, respectively) and a 99.9% Confidence Level. The online-questionnaire was sent to 600 GDs and all endodontists (175) working in Saudi Arabia. A reminder was emailed after 10 weeks to encourage non-respondents to complete the questionnaire. Responses, were collected and converted into numerical data which were analysed using the Chi-square test  (p  = 0.05 ) .    Results  Significantly most respondents (71.9%) used NiTi-RIs  (p < 0.001) ; with more endodontists (96.9%) than GDs (60%). Most users (62.5%) had been using NiTi-RIs for  More than 3 years (p < 0001) . The trend of using NiTi-RIs increased as  participants’ experience  and the number of  root-canal treatments performed per week  increased  (p = 0.021) . While most respondents (45.3%) used NiTi-RIs because of  faster root-canal preparation , the majority of non-users (85.3%) didn’t do so because of  high cost . The highest proportion (43.3%) reported  better undergraduate education  as the most important factor that can significantly increase NiTi-RIs usage. The majority (91.8%) prepared  glide-path  before using NiTi-RIs; especially with  stainless steel hand-files  (63.3%).    Conclusions  NiTi-RIs are relatively well adopted in Saudi dental practice. However,  better education , especially during undergraduate training and  lower cost  can increase their usage. Overall, clinicians showed good awareness of NiTi-RIs usage aspects which reflected on usage modalities.

Modalities of using endodontic nickel-titanium rotary instruments and factors influencing their implementation in dental practice