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

INTRODUCTION: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.