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CHAPTER XVII.

THE TREATMENT AND FILLING OF ROOT CANALS.

By Henry H. Burchard, M. D., D. D. S.

Pathological Conditions.
The modes of treatment of the pulp chambers and canals of teeth
containing non-vital pulps, or those in which the pulp is absent, are
determined and governed by the pathological conditions present. These
conditions may be broadly divided into aseptic and septic ; i. e. those
which have not been invaded by micro-organisms, the others those in
which the pulp or its remnants furnish the soil in which the develop-
ment of micro-organisms has taken place.
The first class includes those cases in which the pulp has been inten-
tionally devitalized en masse, and also those in which the organ has
undergone a process known as mummification, or dry gangrene. This
latter condition is occasionally found as a consequence of traumatic
death of the pulp without exposure, and sometimes as a sequel of
attempts at conservation of exposed pulps by capping them with zinc
oxychlorid.
The septic cases may be divided into classes according to the depth
of invasion of septic organisms ; they range from superficial ulceration
of the pulp, to its disorganization through the agency of ])utrefaction,
and the infection of the tissues beyond the apex of the root.
Immediately upon or even before exposure of the dental pulp,
its surface, and subsequently its substance, is invaded by several
of the many forms of organisms which find a habitat in the human
mouth.
The first of the septic cases are those in which organisms have
invaded the coronal portion of the pulp and destroyed part of its sub-
stance—through a process of ulceration. Such cases become aseptic
through the removal of the pulp en masse, provided no organisms be
carried into the canal during or subsequent to the removal of the
pulp.
The second class of cases comprises those in which septic organisms
have invaded the pulp along the direction of its veins and destroyed
the mass of the organ through a process of suppuration. In these cases
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