Evolution of root canal obturation philosophy and materials: from mechanical filling to biological regeneration

Abstract Root canal obturation has evolved over the past two centuries with the advancement in root canal instrumentation and irrigation, as well as endodontic microbiology, biomaterials science and regenerative medicine. Traditionally, obturation was regarded as a mechanical procedure aimed at filling and sealing the disinfected root canal system with inert materials to prevent bacterial leakage and reinfection. The introduction of gutta-percha and root canal sealers established the foundation of modern obturation, while subsequent developments focused on improving sealing ability, dimensional stability, adaptability, and clinical handling through techniques such as lateral condensation, warm vertical compaction, thermoplasticized injectable systems, carrier-based obturation, and contemporary single-cone techniques. However, increasing understanding of biofilm-mediated infection has shifted emphasis toward effective disinfection and biological healing rather than obturation technique alone. The emergence of calcium silicate–based bioceramic sealers and other smart biomaterials has further transformed obturation concepts by introducing bioactive, antimicrobial, mineralizing, and regenerative properties. In addition, regenerative endodontic procedures and tissue engineering strategies have challenged the traditional requirement of canal filling by demonstrating that biologic tissue ingrowth may achieve favorable outcomes under appropriate conditions. Collectively, these developments indicate that obturation is evolving from a passive space filling procedure into a future biologically responsive and patient-specific therapeutic strategy.