The significance of knowing the pulp space anatomy

• the goal of endodontic therapy is to seal the root canal system after removing all vital or necrotic tissue and microorganisms from the pulp space
  • it’s difficult to attain the goal because of how complex the internal anatomy of teeth
  • Residual bacteria and debris may remain relatively unaffected in the missed canal system or even in the unprepared canal walls, isthmuses, lateral canals, apical ramifications, and recesses from oval/flattened canals which may compromise the successful treatment outcome.
  • Thus, a thorough understanding of the number of canals, of the inner-canal morphology, and the variations in all groups of teeth is a basic requirement for successful endodontic therapy.
• Knowing the ideal (or most frequently encountered) tooth shape isn’t enough, more detailed knowledge of root number and root canal system anatomy is required.
  • one must anticipate variation in chamber size and depth from the occlusal surface, the canal size, shape, length, curvature, branches, lateral canals, and apical accessory canals, to mention just a few variables.
  • These variations may or may not be clearly seen in a standard periapical radiographic image.
• One should be able to develop a 3D visualization, both in longitudinal and in cross-section while still using clinical tactile sense to guide a file toward the apical foramen or apical terminus.