Cleaning Isthmus Areas

A bacteria free isthmus is essential.

Isthmuses are narrow anatomic areas containing pulp and/or necrotic tissue. The isthmus should be disinfected and cleaned as thoroughly as possible. When instrumenting canals with traditional files, a large portion of wall areas remains untouched. Ultrasonic tips can help to considerably raise the percentage of cleaned surface and enhance the removal of biofilm.


E18 – Isthmus

The Isthmus tip is used for selective dentin removal in ishtmus or low access areas, and it is an excellent choice for retreatments, clearing root canal and removing Gutta-Percha.


E18D – Isthmus Diamond

The Isthmus D tip is specially developed to treat ishtmus or low access areas in which end and side cutting action is necessary. 


E4D – Long Diamond

The E4D provides safe and effective side cutting or pulpal floor dentin removal. Essential in enlarging access and troughing groove walls.


E2D – Conical Diamond

The E2D – Conical Diamond is indicated for both side and end cutting, enlarging the ishtmus and troughing.


R2 – Flatsonic™

The R2 Flatsonic™ tip is used for selective cleaning of areas left untouched by traditional files. It is an excellent choice for retreatments, especially in long oval canals, where even the R1 Clearsonic would not fit. Very effective in the removal of Gutta-Percha.

Files Aren’t Enough to Clean Isthmus.

The root canal is NOT round

Root canals are not round but in fact flat and many different shapes. Traditional files are unable to clean the isthmus.

Files can’t thoroughly clean

Traditional Files don’t touch every wall. If there is no touching, bacterias are not removed.


Canal Walls Untouched by Traditional Files

Step-by-Step Isthmus Cleaning

1 – Clean the isthmus using a proper diameter ultrasonic tip. For thinner canals, we recommend the ISTHMUS, ISTHMUS D or Clearsonic tips. For larger canals, the E4 or the E4D.

2 – Touch the canal walls with the ultrasonic tip in order to dissociate the biofilm. Diamond coated tips have a higher cutting action. Therefore, they must be used with caution, preferably by professionals that have magnification equipment available.

3 –  Finally, you may turn on the water flow to rinse and remove debris created during the procedure.

<img src=" Illustrations-Cleaning-Isthmus-4.png" alt="Cleaning Isthmus Canal after instrumentation with files.">

1. Canals after instrumentation with files.

<img src="Illustrations-Cleaning-Isthmus-5.png" alt="Cleaning Isthmus Ultrasonic tip touching isthmus wall.">

2. The ultrasonic insert must touch all isthmus walls.

3. Clean isthmus area.

<img src=" Isthmus-1.jpg" alt="Cleaning Isthmus Premolar after preparation with traditional files.">

Premolar after preparation with traditional files

<img src="Isthmus-2.jpg" alt="Isthmus D cleaning isthmus">

ISTHMUS D tip in action, cleaning the isthmus area

<img src="Isthmus-3.jpg" alt="cleaned isthmus">

Clean canal walls after procedure with ISTHMUS D ultrasonic tip

Use the tip gently, as if you were using a 0.5mm mechanical pencil. The cutting does not come from the pressure applied, but from the vibration. Avoid working for more than 30 seconds without water flow – it can damage the hand piece due to overheating.

Dr Mounce Quote

“For the top level endodontist and general dentist alike, Helse tips are unmatched in quality, price and function. When it matters, for me, it’s Helse.”

Richard Mounce, DDS

Starter Packs to get you going.

Starter Packs to get you going.

We’ve assembled three separate starter packs packaged with a procedure field guide to get you started supercharging ultrasonics in your practice.

Endo Starter Pack

The Endo Starter Pack includes 6 Ultrasonics Tips to get you started with Pulp Chamber, Middle Third and Activation procedures.

Endo Master Pack

The Endo Master Pack includes 12 Ultrasonics Tips for Pulp Chamber, Middle Third, Activation, Post Removal and Retreatment procedures.

Endo Guru Pack

The Endo Guru Pack includes 18 Ultrasonics Tips for maximum flexibility with Pulp Chamber, Middle Third, Activation,Post Removal, Apical Surgery and Retreatment procedures.


When purchasing tips we offer savings for every 6 tips you add to your cart. No discount codes just add to your cart and start saving.