Assessment of Dental Students' Knowledge and Practice on Root Canal Irrigation

Irrigation is a fundamental phase of root canal treatment, directly influencing disinfection efficacy and treatment prognosis. Understanding how well dental students integrate evidence-based irrigation principles into their clinical practice is essential for improving endodontic education and patient care outcomes.

A cross-sectional survey was administered to 150 undergraduate dental students (79 fourth-year and 71 fifth-year students) at Trakya University. The 25-item questionnaire, validated through expert review, assessed theoretical understanding of irrigants, clinical protocol adherence, activation system usage, complication management, and information-seeking behaviors. Responses were analyzed using descriptive statistics and Chi-square or Fisher's exact tests, with Bonferroni correction where applicable.

Both groups demonstrated high theoretical knowledge of irrigant properties and interactions, with correct responses recorded for sodium hypochlorite (NaOCl) mechanism, chlorhexidine rationale, ethylenediaminetetraacetic acid (EDTA) purpose, and NaOCl-EDTA interaction. However, only 33 (41.8%) fourth-year and 29 (40.8%) fifth-year students identified the recommended irrigant volume (>20 mL). Fourth-year students more frequently irrigated after every file change (71 (89.9%) vs. 50 (70.4%), p = 0.005), whereas fifth-year students more often reported reducing irrigation duration due to time constraints (27 (38.0%) vs. 15 (19.0%), p = 0.015). Use of activation techniques was low (10 (12.7%) vs. 11 (15.5%)), and reliance on manual irrigation predominated. A significant difference was observed in the use of side-vented or closed-ended needles (65 (82.3%) vs. 43 (60.6%), p = 0.005). Regarding education, most students reported receiving only theoretical training in activation systems (111 (74.0%)), while nearly half of fifth-years (33 (46.5%)) indicated difficulty in designing case-specific protocols compared with fourth-years (18 (22.8%), p = 0.003). Students primarily relied on peer consultation and internet resources for additional information.

While foundational knowledge of irrigants is strong, translation into consistent, evidence-based clinical practice remains limited. Curricular strategies should incorporate structured, hands-on training with activation systems, simulation of complex cases, and integration of guideline-based decision-making frameworks to enhance clinical competence.