Abstract
BACKGROUND: The clinical translation of natural nanomaterials and smart delivery systems in regenerative dentistry relies heavily on practitioner acceptance; however, end-user perspectives remain under-investigated. OBJECTIVE: This study evaluated dental practitioners' self-reported knowledge, attitudes, and perceived barriers regarding these innovations. The questionnaire examined stated intention and self-reported willingness, not clinical behaviour. METHODS: A cross-sectional survey using convenience sampling was conducted among 713 Romanian dentists. Statistical analysis included Chi-square tests and odds ratio estimation to identify factors associated with willingness to adopt nano-formulations. RESULTS: Self-reported familiarity was moderate, with only 19.1% of respondents describing themselves as "very familiar" with nanodentistry; nevertheless, 77.3% believed natural nano-formulations could match synthetic efficacy. High costs (36.5%), lack of long-term evidence (35.9%), and staining concerns (46.0%) were identified as primary perceived barriers. Experience with digital technologies (CAD/CAM) was significantly associated with a positive attitude toward adoption (OR = 2.05, 95% CI: 1.41-2.98, p < 0.001). CONCLUSIONS: Respondents demonstrated a generally positive attitude toward integrating bioactive nanomaterials, though widespread adoption is currently limited by economic, educational, and evidentiary gaps. Future strategies should focus on establishing clear clinical protocols, providing robust long-term safety data, and improving the aesthetic stability of natural biomaterials.