When performing a root canal procedure, it’s imperative that after instrumentation, the clinician cleanses and disinfects the canal thoroughly with endodontic irrigants—even where instruments can’t reach. However, this can prove tricky, as irrigants must reach where they are needed without expressing beyond the bounds of the canal—breaking through apical tissues, potentially damaging healthy tissue. Dr. Dan Fischer says, “The basic concept of irrigation in endodontics is to get the smallest cannula down close to the apex, but shy of the foramen, and to irrigate from the bottom up. It is imperative to start from the bottom to prohibit trapping air in the canal—it is very difficult to displace an air bubble when you’re filling the canal from the top down. However, the deeper the canal, the more difficult it is to get the cannula down to the apical region of the tooth.”
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