WHY DOES MY ENDODONTIST SOMETIMES FILL SHORT???
As endodontists, we attempt to fill to the anatomic constriction in every case. Sometimes this portal of exit can be quite far from the ‘radiographic apex’ due to dilacerations, a tooth’s anatomy, or angulation of the radiation source with respect to the tooth. This is why we heavily rely on electronic apex locators which are considerably more accurate than conventional PA images. Carefully inspect the images below. The pre-operative PA looks like the length control is nearly perfect; however, when the tooth is extracted, you can note that the thermafil carriers are actually extruded ~4 mm beyond the root tip. In this case, filling ‘just perfectly’ to the radiographic apex actually meant that the dentist extruded thermafil carriers directly into the IAN.