“…and I’ve never seen a canal exit short of the radiographic apex,” is what a general practitioner told me a few years ago with a smug kind of experience-teaches-me-as-much-as-an-advanced-specialty-program-does kind of look. Funny thing is, seeing how recently he had graduated he couldn’t even have been that experienced.

As a specialist, this kind of rhetoric just gets your goat. But as specialists, we know from where this kind of commentary arises.

This guy probably took a few Endo (root canal) courses where he learned some Schilder Technique¹ basics, like “fill to the radiographic apex” and the lecturer didn’t bother (or didn’t know themselves) that teeth such as the one on the right exist.

Sure, the Schilder technique mandates a fill to the radiographic apex rather than the canal terminus, but with the understanding that you’ll be filling a little long every so often. This rational was developed prior to current apex locator technology and isn’t really practical today². If we can stay out of the periodontal ligament and supporting tissues with our obturation materials, we minimize the risk of persistent sensitivity and/or foreign body reactions.

1. Schilder H. Filling root canals in three dimensions. Dent Clin North Am. 1967 Nov;:723-44. [↩]
2. Stein TJ, Corcoran JF. Radiographic “working length” revisited. Oral Surg Oral Med Oral Pathol. 1992 Dec;74(6):796-800. [↩]