Abstract
This study assessed the knowledge, attitude, practice, and challenges of dental practitioners regarding the tug-back technique in endodontics—a basic step in achieving an effective apical seal in root canal therapy. A cross-sectional survey was conducted among 154 general dentists and endodontic specialists. Descriptive statistics and Fisher's Exact Test were employed to assess the data. A response rate of 60% was achieved, with most respondents being female (77.3%) and early-career practitioners (66.9%). Over half (57.1%) were very familiar with the technique and knew its importance. Radiographic confirmation (63.6%) and tactile feedback (68.8%) were the most common methods of confirmation. Differentiating between true and false tug-back and inadequate canal shaping were the most challenging. A significant association between type of practice and confidence in perceiving true tug-back (p = 0.0108) but not experience and technique used (p = 0.9019) was found. The study highlights the need for specialized training and hands-on workshops to enhance practitioners' proficiency and diagnostic confidence in applying the tug-back method.