6 requirement and the endodontic certiﬁcate accredited by the American Association of Endodontists. Universities and manufacturing companies should col- laborate to have formal and informal communication with the end users in order to overcome the reasons for not using NTRF. This can be achieved through several contin- uing educational courses distributed among all the regions and focusing on regions in which use is particularly low. Furthermore, manufacturing companies should encourage new users by oﬀering aﬀordable, discounted prices. We did not cover the eﬀect of education courses on the adoption of NTRF in terms of quantity and quality, so further studies are needed to evaluate such an eﬀect. Our results indicate the need for more hands-on workshops and lectures to increase the conﬁdence of dentists with regard to overcoming the fear of breakage. It appears that both the Saudi Dental Society and the Saudi Endodontic Society should address these issues in the dental societies and dental schools to improve skills and user acceptance. 5. Conclusion This paper surveyed the endodontic performance and atti- tude towards NTRF uptake by diﬀerent groups of practition- ers residing in Saudi Arabia. Within the limitations of this study, we found that NTRF usage was not as widespread as in other developing countries. We suggested that collaboration between universities, dental societies, and manufacturing companies would lead to improved implementation of NTRF in undergraduate and postgraduate curriculums, as would the provision of more focused educational courses. Further studies are needed to evaluate the eﬀect of these courses on the usage of NTRF. 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