Knowledge, Attitudes, and Barriers to Vital Pulp Therapy among Dental Practitioners in Zliten, Libya: A Cross-Sectional Study

Abstract

Background: The landscape of conservative dentistry has undergone a massive paradigm shift, moving steadily toward the core philosophy of minimally invasive endodontic management. Rather than defaulting to aggressive, irreversible root canal treatments, modern clinical frameworks prioritize Vital Pulp Therapy (VPT) to salvage pulpal tissues compromised by deep caries or mechanical trauma. This cross-sectional study evaluates the knowledge, attitudes, and operational barriers regarding partial and full pulpotomy among dental practitioners in Zliten, Libya.

Objectives: The primary objective of this investigation is to assess and compare the current level of baseline knowledge, clinical awareness, and attitudes regarding partial and full pulpotomy procedures among general dental practitioners (GDPs) and specialists across both public and private sectors in Zliten, Libya, while systematically identifying the precise cognitive, logistical, and pedagogical hurdles that restrict their regional adoption.

Methodology: Employing a descriptive, analytical, cross-sectional survey-based design, data collection spanned over a two-month period (June to July 2026) within the municipality of Zliten. A sample of N = 70 actively practicing dental professionals completed a validated, high-reliability self-administered questionnaire (Overall Instrument Cronbach's alpha = 0.865) distributed physically across public health centers and private dental clinics.

Results: The findings demonstrated that the overall combined index for practitioners' Knowledge, Attitudes, and Barriers (KAB) was moderate (Mean = 3.49 ± 0.69), directly mirroring their self-reported Clinical Practice (CP) frequency, which fell into the 'sometimes' range (Mean = 3.36 ± 0.68). A stark knowledge-practice gap was exposed regarding isolation; clinicians expressed high theoretical conviction that operating without a rubber dam escalates clinical failure rates (Mean = 4.01), yet strict procedural compliance dropped to a moderate level (Mean = 3.19). Inferential analysis revealed that female practitioners achieved significantly higher baseline knowledge scores than males (p = 0.004). More importantly, attendance at a Continuing Professional Education (CPE) workshop within the past three years strongly predicted superior theoretical knowledge (p = 0.0003) and practical execution (p = 0.001). Conversely, One-Way ANOVA tests showed no statistically significant differences based on experience years, academic background, or workplace sector ( p >0.05).

Conclusion: This study highlights a profound knowledge-practice gap heavily driven by localized systemic and operational barriers, such as high procurement costs of advanced bioceramics, severe patient volume constraints in public polyclinics, and a collective pedagogical shortfall in undergraduate dental curricula. To transition local dental practice toward biologically sound, minimally invasive endodontics, a coordinated curricular restructuring and institutional reform (such as material subsidization and strict auditing of aseptic protocols) are strictly mandatory.