8 However, if one cannot achieve a dry root canal system that is free from blood or exudate, then the suggested course of action would be to dress the tooth with an inter-appointment dressing. Obturation should only be carried out following thorough chemo-mechanical debridement of the root canal system 7 and, if the root canal system is dry and time permits, obturating at the same visit is recommended. The timing involved with obturation raises the issue of single versus multiple visit treatment. Prevent periapical or periodontal fluids percolating into the root canals and feeding microorganismsĮntomb any residual microorganisms that have survived the debridement and disinfection stages of treatment, in order to prevent their proliferation and pathogenicity. Prevent coronal leakage of microorganisms or potential nutrients to support their growth into the dead space of the root canal system The establishment of a well obturated system would serve three main functions: 6 While a perfect airtight or hermatic seal is unachievable in reality, every effort should be made to reach this target. The aim of obturation is to establish a fluid-tight barrier with the aim of protecting the periradicular tissues from microorganisms that reside in the oral cavity.
However, it is important to recognise that the responsibility does not end here the coronal seal forms an integral part of endodontic treatment and therefore plays a vital role in the treatment's success.
2, 3 The obturation stage is carried out to fill the root canal 4 in an attempt to provide a hermetic seal from the coronal orifice of the canal to the apical foramen at the cemento-dentinal junction. The removal of microorganisms is primarily achieved during the debridement and disinfection stages of treatment. 1 The elimination of microorganisms and their by-products is, therefore, the key to success. Since the seminal research by Kakehashi in 1965, the role of microorganisms and their by-products has been demonstrated countless times as the main causative factor in the aetiology of apical periodontitis. When the pulp is rendered non–viable, root canal treatment attempts to fulfil its aim by debridement, disinfection and obturation of the root canal system. The ultimate biologic aim of root canal treatment is the prevention or cure of apical periodontitis.
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