illing Root Canals in Three Dimensions

OE — Volume 32, Number 4, April 2006 he final objective of endodontic procedures should be the total obturation of the root canal space. Biologic necessity requires the elimination of the protein degradation roducts, bacteria, and bacterial toxins which emanate from necrotic and gangrenous oot canals. While these irritants may be eliminated by extraction of the tooth, the health f the dentition is secured more soundly if they are eliminated by the cleaning and haping, sterilization, and total obturation of the root canal system. In the final analysis, t is the sealing off of the complex root canal system from the periodontal ligament and one which insures the health of the attachment apparatus against breakdown of enddontic origin. Under unusual circumstances (note paper by Dr. Siskin in this symposium), it may e necessary to seal off the root canal by means of a reverse root end filling, while ncarcerating potentially injurious agents inside the tooth. For the most part, however, t is desirable and possible to clean and shape the root canals in their entirety, and to bturate them totally. Two important elements must be considered when judging the alue of total obturation of the root canal system: 1. The inability to know with certainty hether the apex has been sealed in a nonsurgical procedure; 2. The existence of umerous accessory canals, many of which contain significant potential for the prouction of lateral root abscesses (see the paper by Dr. Langeland).