Root canal systems are complex, often interconnected, channels that do not conform to our file shapes. Cleaning and shaping of the systems is just part of the disinfection, the more we understand about the canal anatomy the more we can recognise that irrigation is crucial to Endodontics.

For any tooth it is easier if you bend the irrigation needle to allow access to the canals especially upper molars and the MB canals.

Recently I was reading one of Dr Omar Ikram’s Facebook posts @specialistendo and learnt a tip that has really helped me irrigate with more precision.

Instead of just irrigating to an arbitrary length, bend the irrigation needle 2mm short of your working length and allow that measurement to ensure you’re irrigating to the precise location you want to.

Preparation size and your irrigation needle go hand in hand!

It’s the simple tips that make the biggest difference and this one recently opened my mind regarding irrigation. The size of your irrigation needle impacts on how close to the apex you can irrigate.

25G needle = ISO 50

27G Needle = ISO 40

30G Needle = ISO 30

This makes sense and is makes it easy to predict where the irrigation needle is able to get to. However, what if the final ISO size is less than your needle gauge? It then becomes important to either activate your irrigate with ultrasonic acitvation or with GP pumping (manually pump GP cone in and out of canal).

I had not really thought this through before. Now I can predict to when I should be able to get the needle tip and now I can say with more confidence that I’m irrigating properly.

For more on Endodontics, I highly recommend you follow Dr Omar Ikram on specialist Endo Crows Nest – Clinical Hacks to get regular Endodontic tips.

David is a recent graduate dentist working in private practice in regional NSW, Australia. Read more at

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