E N D O D O N T I C S
redictable endodontic successdemands accurate determina-tion of,and strict adherence tothe preparation length of the rootcanal space in order to create asmall wound site and good healingconditions.
Each portal of exit(POE) on the root face has biolog-ic significance;this includesthe furcal canals of bifurca-tions and trifurcations,lat-eral and accessory arboriza-tions and the myriad of api-cal termini (Figs.1A-D).The ability to distinguishbetween the inner-most(physiologic/histologic fora-men) and outer-most (ana-tomic foramen) diameters of theapical terminus is essential to thecreation of the Apical ControlZone.
The Apical Control Zone isa mechanical alteration of theapical terminus of the root canalspace that addresses the rheologyof thermolabile filling materials,offering resistance and matrixstyle retention form against thecondensation pressures of obtu-ration (Figs.2A-C).The determination of the in-strumentation finishing level isone of the primary factors associ-ated with the resolution of anendodontic infection both clinical-ly and histologically.
The major-ity of studies postulate that opti-mal success rates occur wheninstrumentation,debridement,disinfection and obturation arecontained within the region of api-cal narrowing (bracketed by theminor apical diameter and apicalforamen.
In teeth/roots withapical periodontitis (AP) for exam-ple,a millimeter loss in workinglength can increase the chance of treatment failure by 14 percent.
The Toronto Study notedthat the highest healingrate differential (15 percent)was observed in teeth with AP that were most likelyover-instrumented resultingin transportation of contam-inated debris periapically.
The evidence is indisputablethat electronic root canallength measuring devicesprovide significantly more accu-rate results than radiographs
and therefore offer greater controlof the creation of the ApicalControl Zone (Fig.3).In 1942,Suzuki discoveredthat the electrical resistance (sin-
The New Era ofForamenal Location
Kenneth S. Serota, DDS, MMSc, Jorge Vera DDS,Frederick Barnett, DMD, Yosef Nahmias, DDS, MSc
New modes ofdebridement and disinfectionare constantly arrivingin the endodonticarmamentarium.