Instrumentation and Obturation of the Apical Third of Root Canals: Addressing the Forgotten Dimension
Mian K Iqbal, DMD, MS; Joanna Ku, DDS;
Abstract:
Modern developments in instrument design and obturation techniques have greatly improved
the efficiency of conventional endodontic therapy. Nickel titanium rotary instruments allow the
practitioner to prepare canals more quickly and predictably. However, apical preparations by
such instruments fail to address the anatomical complexity of the root canal system.
Morphologic studies consistently show that canals are mostly oval or irregular in shape;
therefore, round preparations by instrumentation result in uninstrumented areas of the root
canal system. This is of particular importance in the apical third and in cases of preexisting
periapical pathology, where residual bacteria may reside and cause persistent infections. How
beneficial are these new instrumentation and obturation techniques to the basic purpose of
root canal therapy in eradicating bacteria? This article presents the shortcomings of current
instrumentation and obturation techniques and offers possible solutions to improve the
outcome of endodontic therapy.
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