# Patterns and Practices in the Use of Endodontic Materials: Insights from Romanian Dental Practices
## 4 Discussions
The study also highlighted differences in biocercamic sealer application between general dental practitioners and endodontic specialists, underscoring the need for standardized usage guidelines [12]. In [PERSON] et al. 's study [25], another study on the current practices of dentists in Romania, it is mentioned that when questioned about the use of biocercamics in their daily practice, 61% of respondents with postgraduate training in endodonticspreferred the use of bioceramics for filling root canals [25]; however, in our study, the percentage of dentists with practice limited to endodontics is very small. Although it belongs to the category of biomaterials, being biologically compatible, mechanical, functional, and corrosion-resistant and quickly adapting to clinical and laboratory technologies [5], clinicians face challenges with bioceramic sealers due to difficulties in removal during nonsurgical retreatments, variable clinical practices, and limited evidence supporting their use [63; 64; 65]. Regarding filling techniques, participants in the study overwhelmingly prefer warm techniques (74.13%) over cold techniques (25.87%). This preference aligns with literature findings, as warm thermoplastic filling materials offer superior dental adaptation and a more uniform seal than traditional cold lateral condensation methods [66]. Warm guttapercha techniques also result in fewer voids during filling and superior outcomes in apical sealing, adaptation to root canal morphology, and reduced void formation [67]. There is no conclusive evidence in endodontics favoring single-visit versus multiple-visit root canal treatments. Both approaches demonstrate similar effectiveness and complication rates [68]. Single-visit endodontics can be particularly effective for cases of irreversible pulpitis when carefully selected and following established protocols [69]. If periodontal pathology is also present, the treatment could be extended as needed, combining nonsurgical periodontal therapy with a 7-day course of antibiotics [70]. The decision between single or multiple visits should consider factors such as case complexity, patient comfort, and treatment success rates, emphasizing the importance of individualized treatment planning in Romanian endodontic practices. More than half of the participants in this study were observed to perform endodontic treatment in two separate sessions. This study complements the findings of the endodontic materials research by showcasing the broader trends in material selection across the endodontic field. By identifying preferences, influencing factors, and trends, this research and the study of [PERSON] et al. [71] and [PERSON] et al. [25] seek to contribute to a better understanding of regional practices and provide insights that can improve international collaboration and significantly innovate and advance dental care. These studies contribute to the growing shift towards more advanced materials, providing valuable data for manufacturers, educators, and policymakers in the dental field. They underscore the evolving landscape of dental materials in Romania, pointing to challenges and opportunities for improving treatment outcomes and reflecting global trends in dental material innovation [25; 71]. The study's limitations include the potential for sample bias; when analyzing the results, it is essential to recognize the limitations inherent in cross-sectional surveys, such as possible biases arising from questionnaires. One key aspect to consider is the need for diverse representation in the sample, which can help ensure a comprehensive understanding of contemporary dental practices. Emerging trends, such as the increasing reliance on CBCT (Cone Beam Computed Tomography) examination and the use of magnification tools, hold significant potential for advancing the precision and scope of endodontic procedures. These developments could form the basis of a broader study, allowing for a detailed exploration of their impact on diagnostic accuracy and clinical outcomes.