The fate and the role of bacteria left in root dentinal tubules

In this article the question of the relevance and consequences of bacteria remaining in the tubules of root dentine after cleaning and shaping of the root canal space is addressed. A second aim is to discuss the necessity of clinical measures taken to eradicate those bacteria that are presumed to survive there. The available clinical and experimental evidence supports the use of antibacterial dressings in cases where the root canal space remains temporarily unobturated after removal of necrotic and infected pulp tissue. There is no evidence, however, that special measures should be taken to kill the bacteria in the dentinal tubules. Should time permit, a sound obturation technique immediately following the cleaning, shaping and disinfection phases allows the remaining bacteria in the tubules to be either inactivated or prevented from repopulating the (former) canal space. In the vast majority of cases, those bacteria appear not to jeopardize the successful outcome of root canal treatment.