The role of lateral (accessory) canals in root canal treatment has been a subject of debate. These canals connect
pulp space and periodontium. Irritants in the root canal
system, such as bacteria and necrotic debris, may leak
into the lateral periodontium and initiate infl ammation
(see Figure 17-1).
Histologic examination of roots after débridement
shows that lateral canals are rarely if ever débrided.
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There is no significant difference in the ability of various
obturation techniques to fi ll the main canal. However,
certain techniques tend to force materials into the lateral
canals.
When the main canal space is adequately débrided and
obturated, lateral lesions adjacent to lateral canals heal as
readily as periapical lesions. This occurs whether obturating material has or has not been expressed into the lateral
canal.
The conclusion is that obturation of lateral canals is
inconsequential to the outcome of most root canal treatments despite proponents of certain techniques that
claim to fi ll lateral canals.