[Fundamental biologic considerations in endodontics]

Over the years a substantial body of scientific data has accumulated suggesting that most pulpal and periapical disease processes are induced and maintained by bacterial organisms. On the basis of this knowledge, this review paper discusses rationales and essential steps in endodontic therapy. It is concluded that the focus in pulpectomy procedures (vital pulp therapy) is on preventing bacteria from establishing themselves in the root canal. In cases of infected pulp necrosis, treatment is geared towards the complete elimination of pathogenic organisms that are already present in the root canal system. In both instances, vital or necrotic pulp, it is important that such conditions be established to avoid recurrence of infection following treatment.