Prevalence, Location, and

Patency of Accessory Canals

in the Furcation Region of
Permanent Molars

findings lend credence to the fact that interradicular

canals do exist and unite the pulp and periodontium in
an intimate relationship.
Serial histological studies on pulpally involved teeth
by Barrett, Rubach and Mitchell, Seltzer et a l .
Seltzer et a l . and Winter and K r a m e r demonstrated
a high incidence of accessory canals especially in the
bifurcation or trifurcation regions of molars. Although
interradicular pathology was noted in these studies,
not all of the teeth demonstrated aberrant communication between the pulp and periodontium.
Dye studies by Moss et a l . and W i n t e r , in pulpally
involved deciduous molars exhibiting interradicular
pathology, indicated a 20 to 2 3 % frequency of accessory canals in the pulpal floor of these teeth. Recently,
L o w m a n , Burke, and P e l l e u , using a radiopaque dye
in 46 extracted molars, demonstrated a 5 9 % frequency
of patent accessory canals in the coronal and middle
thirds of the roots. Prior to subjecting the teeth to dye
infusion, the root surfaces "were planed with periodontal scalers to simulate a clinical situation" where periodontal therapy was necessary. In situations, where,
due to primary pulpal pathosis, the attachment apparatus is involved, endodontic therapy usually results in
complete periodontal regeneration without any periodontal therapy.
Topographical studies by Koenigs, Brilliant, and
Foreman, and Burch and H u l e n have confirmed
the presence and characteristics of numerous accessory
foramina in the furcation areas of permanent molars.
According to Burch and Hulen as many as 7 6 % of the
molars studied exhibited multiple foramina in the furcation area, although their patency between the pulp
chamber and the external root surface was not established.
The concensus of the literature is that there is a
great deal of intercommunication between the pulp
and the periodontium via accessory canals. However,
an accurate prevalence of patent canals in the furcation
region of permanent molars has yet to be demonstrated.
1

by
JAMES L . GUTMANN, D.D.S.*
INTIMATE
anatomical relation of the pulp to
periodontal tissue via accessory canals has been established by many investigators. In pathological situations, interactions between the two tissues can occur
via toxic products and/or inflammatory extensions,
with resultant concomitant pulpal-periodontal breakdown. Pulpal-periodontal interactions have been observed clinically in the furcation region of maxillary
and mandibular permanent molars (Figs. 1 A and B )
following pulpal injury. Although a review of the
literature presents strong documentation for the presence of accessory canals in the furcation region of
molars and their potential involvement as pathways
for the transmission of disease processes, an accurate
anatomical prevalence of accessory canals is lacking.
The purpose of this study is to determine the prevalence, location, and patency of accessory canals in the
furcation region of permament molars.

23

REVIEW

Early attempts to demonstrate anatomically these

fine ramifications in the root canal system proved
inconclusive. H e s s gives an excellent account of the
methods employed at the beginning of the 20th century
(molten metal castings, india ink perfusion, celluloid,
vulcanite castings). Gross reproduction of the internal
tooth anatomy was adequate with intricate variations
seldom seen.
More recently, while investigating the vascular architecture of the human dental pulp, Russell and K r a m e r , K r a m e r , and Saunders utilized perfusion
techniques to establish the intricate relationship of
pulpal and periodontal tissues. Their investigations
showed that particularly in the bifurcation or trifurcation area large vessels may be found running through
the radicular dentine to supply one root canal, sometimes appearing to contribute more to the root canal
vascular system than the vessels entering the apical
foramen. Smaller vessels running between the root
canal and the periodontal membrane are relatively
common and almost always these connections consist
of a pair of vessels, one large and one small. These
16

18

21

22

1-15

17

10

2 0

T H E

LITERATURE

24

MATERIALS

A N D

METHODS

One hundred and two extracted permanent teeth

(51 maxillary and 51 mandibular first and second
molars) were selected at random and stored in normal
saline. Criteria used for selection were the presence of
an intact crown and root structure. If any teeth exhibited minor pit and fissure caries, they were repaired
with amalgam.
The teeth were first placed in a 2 . 5 % solution of
sodium hypochloritet for twenty minutes for surface
cleansing. Sodium hypochlorite was not used internally
because it was determined previously that long periods
of exposure to the hypochlorite solution caused decalcification of the tooth structure. The teeth were rinsed

19

* C h a i r m a n , Department of Endodontics, Baltimore College of

Dental Surgery, Dental School, University of Maryland at Baltimore,
666 W . Baltimore St., B a l t i m o r e , M d 21201.

t C I o r o x (The Clorox C o . , O a k l a n d , Calif), diluted 1:1

water.

21

with

22

J . Periodontol.
January, 1978

Gutmann

chamber (Fig. 3). Safranin dye (red) was introduced

down the tubes into the pulp chambers of the teeth
with a pipette. A vacuum of 525 mm of mercury was
applied to the external root surfaces for a maximum of
15 minutes. Once the vacuum was applied the teeth
were continuously observed for any red staining of the
furcation region. A s soon as any evidence of staining
appeared, the tooth was removed in order to maintain
a discrete marking on the cemental surface.
RESULTS

In order to understand the findings of this study

accurately the parameters of observation must be defined. The "furcation" applies only to that area where
the roots separate from the coronal one-third of the
root system. The "furcation region" designates the
actual furcation of each tooth plus an area 4 mm down
the internal aspect of the root surfaces. A l s o , in many
cases it was not possible to detect with accuracy the

F I G U R E 1A and B . Destruction
of bone in the
region of mandibular molars due to pulpal disease.

furcation

in tap water and the crowns were reduced circumferentially to eliminate any irregularities, i.e. grooves,
ridges, etc. The pulp chamber was entered occlusally
according to standard endodontic techniques and the
gross tissue was debrided with X X X X F and X X X F
broaches.*
The teeth were stored in a 3% hydrogen peroxide
solution for 3 weeks and the solution was changed
every 3 to 4 days. Hibbard and Ireland determined
that decalcification does not occur in the presence of
3 % H 0 . Likewise, hydrogen peroxide does not dissolve organic debris but destroys the tissue attachment
to the tooth allowing for easy tissue debridement.
The teeth were rinsed in tap water for 20 minutes
and placed in 9 5 % alcohol for 24 hours after which
they were air dried. A 1-inch section of x 6
rubber latex tubingt was placed around the crown of
each tooth and was secured with 0.18 stainless steel
wire.t R e d sticky wax was applied to the apical onethird of each root to seal the apical foramen. (Fig. 2)
The rubber tubing with attached tooth was secured to
a glass tube located in a N o . 7 rubber stopper designed
to fit a 500-ml flask which was attached to a vacuum

F I G U R E 2. Maxillary and mandibular molars, totally debrided,

with attached latex tubing secured by stainless steel wire. The
apices have been sealed with sticky wax.

25

*
t
t

U n i o n Broach C o . , L o n g Island C i t y , New Y o r k .

Fisher Scientific, Chicago, 111.
U n i t e k , M o n r o v i a , Calif.
L . D . Caulk C o . , M i l f o r d , D e l .

F I G U R E 3. Maxillary and mandibular molars with attached

tubing are inserted within 500-ml flasks that are attached to a
vacuum system.

Volume 49
Number 1

Accessory Canals 23

differences between first and second molars, hence

they were included under one heading.
From a total of 102 teeth (51 mandibular and 51
maxillary), 29 teeth (28.4%) exhibited 43 patent accessory canals in the "furcation region". In this area
canals were noted in 29.4% of mandibualr molars (21
canals) and 2 7 . 4 % of maxillary molars (22 canals)
(Table I). In the "furcation" only, 25 teeth (24.5%)
demonstrated 30 patent accessory canals. In this area,
canals were noted in 2 5 . 5 % of mandibular molars (14
canals) and 2 3 . 5 % of maxillary molars (16 canals)
(Table II) (Figs. 4 and 5). Canals located on lateral
root surfaces (Table III) were noted in six mandibular
molars (11.8%) and four maxillary molars (7.8%),
10.2% of the total sample. (Fig. 6)
When canals were present, they became evident in
anywhere from 30 to 120 seconds in the majority of
cases. Dye penetration was also observed through the
dentinal tubules to the cemento-dentinal junction (Fig.
7). In areas where the cementum was denuded, the
dye penetrated to the exterior of the tooth. Cracking
and crazing were also evident in the tooth structure,
possibly giving a false impression of accessory canal
formation. Defects of this nature were discernible as
fine lines of dye penetration on the cementum. These
cases were eliminated from the study.

FIGURE 4. Discrete cemented staining located in the "furcation

region" and on the lateral root surface {arrows), presumed to
be patent accessory canals.

DISCUSSION

The etiology of accessory canal formation is well

understood and many authors
have discussed
this developmental defect. Scott and Symons give an
accurate and concise explanation: "There may be ac26, 2 7 , 2 8

27

T A B L E I. Observations in the Furcation

Total number of teeth

Number of teeth with
accessory canals located in the "furcation region"
Total number of canals observed in
the "furcation region"

Region

Mandibular

Maxillary

Total

51
15 (29.4%)

51
14 (27.4%)

102
29 (28.4%)

21

22

43
F I G U R E 5. Pin-point cemental staining located in the
tion" only (arrows).

T A B L E II. Observations in the "Furcation"

Total number of teeth

Number of teeth with
accessory canals located in the "furcation" only
Total number of canals in the "furcat i o n " only

"furca-

T A B L E III. Observations on the "Lateral Root Surface"

only

Mandibular

Maxillary

Total

51
13* ( 2 5 . 5 % )

51
12* ( 2 3 . 5 % )

102
25 (24.5%)

14t

16*

30

* Does not include two teeth which demonstrated accessory canals

in the "furcation region" but not in the " f u r c a t i o n " itself,
t One tooth had two accessory canals in the furcation.
X Four teeth had two accessory canals in the furcation.

Total number of teeth

Number of teeth with
canals located on
the "lateral root
surface" only
Total number of accessory canals located on the " l a t eral root surface"
only

Mandibular

Maxillary

Total

51
6(11.8%)

51
4 (7.8%)

102
10(10.2%)

7*

6t

13

* One tooth had two accessory canals on the lateral root surface,
t T w o teeth had two accessory canals on the lateral root surface.

J. Periodontol.
January, 1978

Gutmann

24

small canals . . . were not studied because in most

instances they do not present a clinical problem".
Ingle feels that "the tissue within the accessory canal
remains vital even though the contents of the main
canal becomes necrotic". H e also states that "many of
the accessory canals are filled upon condensation".
Coolidge is of the opinion that " i n removal of a vital
pulp such inaccessible branches might undergo certain
changes which would lead to the obliteration of this
accessory canal".
From a periodontic standpoint, Matusow feels that
"injury to the supporting periodontal structures . . .
provides a pathway for retrogenic infection of the
injured pulp via apical and lateral foramina". Because
the pulpal tissue can communicate with the periodontal
ligament, Staffileno feels that this "biological relationship is highly significant". Stallard is of the opinion
that the inflammatory process can spread rapidly from
pulpal to periodontal tissues and vice versa. During
periodontal therapy "accessory canals covered by cementum can be re-opened when root planing is excessive". Lowman and co-workers simulating this situation in their study observed a much higher incidence
(59%) of accessory canals in the furcation region.
Stallard also noted, as did Seltzer et a l . , and as was
noted in this study, that a pulpal-periodontal communication can be established via exposed dentinal tubules, thereby establishing another route for inflammatory interactions.
It is important to recognize that the mere presence
of accessory canals does not imply that pathosis will
spread from one entity to another or seriously damage
the affected tissue. Langeland and coworkers demonstrated that although pulpal inflammation can occur
in the presence of periodontal disease from involved
30

31

F I G U R E 6. Cemental staining with apparent foramen

located on the "lateral root surface".

(arrow)

cessory or lateral canals at any point along the root or

neck of a tooth connecting the pulp with the periodontal tissues and quite distant from the apical connection.
These aberrant openings are presumed to be caused
by a localised failure in the formation of Hertwigs
Sheath, with a consequent lack of odontoblast differentiation and dentine formation at this point, so that
the pulp remains in contact with the follicular or
periodontal tissues. The gap in Hertwigs Sheath is
probably produced by the persistence of abnormally
placed blood vessels reaching the p u l p " . According to
Sicher the presence of these accessory canals in the
furcation region of molars can provide an "almost
insurmountable difficulty" in treatment. If this concept
is valid, the data secured in this study have a direct
relationship to many clinical situations.
From an endodontic standpoint, the only therapy
carried out in the pulp chamber of molars is irrigation
and medication. This is where the majority of accessory
canals was noted in this study. If present, accessory
canals could be left patent and a possible ingress of
fluids and bacteria from the periodontium could result.
In addition, failure to seal adequately the coronal
aspect of the tooth following treatment may result in
leakage and communication with the furca through
unfilled accessory canals. A concerted effort to seal
the pulpal floor subsequent to obturation of the root
canals in all posterior teeth is warranted. The canals
located on the lateral root surface receive essentially
the same therapy but through proper biomechanical
cleansing and obturation of the main canals these
defects conceivably can be sealed.
Some authors feel that accessory canals are of little
clinical significance during endodontic therapy. K u t tler felt that "the lateral secondary and accessory
28

22

12

23

29

F I G U R E 7. Dye penetration from the pulp canal

through
patent dentinal tubules to the dentino-cemental junction.

Volume 49
Number 1

Accessory Canals 25

accessory canals, total pulpal disintegration apparently

occurs only when all main apical foramina are involved
by bacterial plaque. Equally important from a periodontal standpoint is the fact that necrotic tissue and
bacterial plaque housed in these canals, although not
severely affecting the pulp, may tend to perpetuate
periodontal furcation lesions making successful therapy
nearly impossible.
The presence of a clincally normal pulp does not
necessarily imply absence of inflammation or atrophic
changes when periodontal disease is present. The cumulative effect of periodontal disease on the pulp has
been shown to be that of inflammation, calcifications,
apposition of calcified tissue, and r e s o r p t i o n
Any
potential compromise of this type to the blood supply
to certain regions of the pulp may hasten pulpal
degeneration and death. Mazur and Massler, however, found that in the presence of periodontal disease
the pulpal condition could vary from almost normal to
one of advanced degeneration. They concluded that
the status of the periodontium does not exert any
great influence on the pulp.
In determining the prevalence of patent accessory
canals in the furcation region of permanent molars,
the findings presented in this study could be clinically
misleading in light of the following facts. First, the
methods of irrigation and debridement were of a
greater magnitude than those used in a clinical situation. Second, the application of a vacuum, which might
far exceed changes in tissue fluid pressure, does not
necessarily represent a normal physiological situation.
Third, dehydration of the tooth structure and the stress
placed on it during extraction may have resulted in
irregularities at the cemental-dentinal junction. Fourth,
in an in vivo situation many of the accessory canals
may become obliterated, calcified, or remain as viable
channels housing normal tissue, thereby playing no
active role in the spread of a disease process.
In view of the findings of this study, the clinical
management of many cases exhibiting signs of periodontal disease in the furcation region of permanent
molars may require only pulpal therapy to eliminate
the causative factors in this disease process, while
other cases may require only periodontal therapy or a
dual approach in t r e a t m e n t .
O f prime importance in determining the proper sequence of treatment
in these cases is the establishment of the pulpal status.
This is best accomplished by noting the presence or
absence of swelling, pulp testing, the characteristics of
pain, if any, and the presence or absence of a sinus
tract and its characteristics.
5,8j 12

32

13,14,33,34

11

SUMMARY

One hundred and two extracted permanent molars

were debrided in 3 % H 0 , sealed at the apex, and
placed in a vacuum chamber. Safranin dye was introduced into the teeth that were placed in a vacuum of
525 mm of H g . Observations were made of the external
2

root surface to determine any staining due to patent

accessory canals.
Accessory canals were demonstrated in the "furcation region" in 2 8 . 4 % of the total sample; 29.4% in
mandibular molars, and 27.4% in maxillary molars.
Of the total sample 2 5 . 5 % exhibited canals in the
"furcation" only, while 10.2% exhibited canals on the
lateral root surface. Communication between the pulp
chamber and the external surface was noted via dentinal tubules, especially when the cementum was denuded.
The salient biologic and pathologic ramifications of
these aberrant canals were discussed along with the
need to establish a differential diagnosis in order to
determine the proper sequence of treatment should
pulpal-periodontal disease exist.

REFERENCES

1. Barrett, M . T . : The internal anatomy of the teeth with

special reference to the pulp with its branches. D Cosmos
67: 581, 1925.
2. Coolidge, E . D . : Anatomy of the root apex in relation
to treatment problems. J Am Dent Assoc 16: 1456, 1929.
3. Johnston, H . B . , and O r b a n , B . : Interradicular pathology as related to accessory root canals. J Endodontia 3: 2 1 ,
1948.
4. Matusow, R . J . : Microbiology of the pulp and periapical tissues: Culture control. Den Clin North Am 11: 549,
1967.
5. Rubach, W . C , and Mitchell, D . F . : Periodontal
disease, accessory canals and pulp pathosis. / Periodontol
36: 3 4 , 1 9 6 5 .
6. Seltzer, S., and Bender, I. B . : The Dental Pulp, ed 2,
chap 15, pp 199-211. Philadelphia and Toronto, J . B .
Lippincott C o . , 1975.
7. Seltzer, S., Bender, I. B . , Nazimov, H . , and Sinai, I.:
Pulpitis-induced interradicular periodontal changes in experimental animals. J Periodontol 38: 124, 1967.
8. Seltzer, S., Bender, I. B . , and Z i o n t z , M . : The interrelationship of pulp and periodontal disease. Oral Surg 16:
1474,1963.
9. Stallard, R . E . : Periodontic-endodontic relationships,
workshop on the biologic basis of modern endodontic practice. Oral Surg 34: 314, 1972.
10. Winter, G . B . , and K r a m e r , I. R . H . : Changes in
periodontal membrane and bone following experimental pulpal injury in deciduous molar teeth in kittens. Arch Oral
Biol 10: 279, 1965.
11. Bender, I. B . , and Seltzer, S.: The effect of periodontal disease on the pulp. Oral Surg 33: 458, 1972.
12. Langeland, K . , Rodriques, H . , and Dowden, W . :
Periodontal disease, bacteria, and pulpal histopathology.
Oral Surg 31 : 257, 1974.
13. Simon, J . H . S., G l i c k , D . H . , and Frank, A . L . : The
relationship of endodontic-periodontic lesions. / Periodontol
43: 2 0 2 , 1 9 7 2 .
14. Schilder, H . : The relationship of periodontics to endodontics. Grossman, L . I. (ed), Trausactions of the Third
International Conference on Endodontics, pp 178-200. Philadelphia, University of Pennsylvania, 1963.
15. Grove, C . J . : The biology of multi-canaliculated roots.
D Cosmos 58: 728, 1916.
16. Hess, W . : The Anatomy of Root Canals of Teeth.
L o n d o n , John B a l e , Sons & Danielsson, L t d . , 1925.
17. Russell, L . H . , and K r a m e r , I. R . H . : Observations
of the vascular architecture of the dental pulp. J Dent Res
f

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January, 1978

Gutmann

26

35: 9 5 7 , 1 9 5 6 .

250,1957.

18. K r a m e r , 1. R . H . : T h e vascular architecture of the

human dental pulp. Arch Oral Biol 2 : 177, 1960.
19. Saunders, R . L . de C . H . : X - R a y microscopy of the
periodontal and dental pulp vessels in the monkey and i n
man. Oral Surg 2 2 : 5 0 3 , 1966.
20. M o s s , S. J . , A d d e l s t o n , H . , and G o l d s m i t h , E . D . :
Histologic study of pulpal floor of deciduous molars. J Am
Dent Assoc 70: 3 7 2 , 1965.
2 1 . W i n t e r , G . B . : Abscess formation in connexion with
deciduous molar teeth. Arch Oral Biol 7: 3 7 3 , 1962.
22. L o w m a n , J . V . , B u r k e , R . S., and Pelleu, G . B . :
Patent accessory canals: Incidence i n molar furcation region.
Oral Surg 36: 5 8 0 , 1973.
23. Koenigs, J . F . , B r i l l i a n t , J . D . , and F o r e m a n , D . W . :
Preliminary scanning electron microscope investigations of
accessory foramina i n the furcation areas of human molar
teeth. Oral Surg 38: 7 7 3 , 1974.
24. B u r c h , J . G . , and H u l e n , S.: A study of the presence
of accessory foramina and the topography of molar furcations. Oral Surg 38: 4 5 1 , 1974.
25. H i b b a r d , E . D . , and Ireland, R . L . : Morphology of
the root canals of the primary molar teeth. J Dent Child 2 4 :

26. Orban's Oral Histology and Embryology,

Sicher, H .
(ed), chap 5, p 152. St. L o u i s , T h e C . V . M o s b y C o . , 1966.
27. Scott, J . H . , and Symons, N . B . B . : Introduction to
Dental Anatomy, chap 1 3 , p 2 3 1 . E d i n b u r g h and L o n d o n ,
E . S. Livingstone, 1971.
28. Sicher, H . : Oral Anatomy, chap 4, pp 2 3 7 - 2 4 0 . St.
L o u i s , T h e C . V . Mosby C o . , 1952.
29. Kuttler, Y . : Microscopic investigation of root A p i c e s .
J Am Dent Assoc 50: 5 4 4 , 1955.
30. Ingle, J . I . : Endodontics, p 7 2 , Philadelphia, L e a and
Febiger, 1965.
3 1 . Staffileno, H . J . : Surgical Management of the Furca
Invasion, pp 1 0 3 - 1 1 9 . Dental Clinics of N o r t h A m e r i c a ,
January, 1969.
32. M a z u r , B . , and Massler, M . : Influence of periodontal
disease on the dental p u l p . Oral Surg 17: 5 9 2 , 1964.
33. H i a t t , W . H . : Periodontal Pocket Elimination
by
Combined Therapy, p 133. D e n t a l Clinics of N o r t h A m e r i c a ,
M a r c h , 1964.
34. Simring, M . , and G o l d b e r g , M . : The pulpal pocket
approach: Retrograde periodontitis. / Periodontol 35: 2 2 ,
1964.

Announcements
THE

L. D. PANKEY

INSTITUTE

The L . D . Pankey Institute for Advanced D e n t a l Education

announces a 5-Day Course for Periodontists M a r c h 27 to M a r c h
31, 1978.
The co-directors of the Department of Periodontics are D r . Frank
Scott, D r . Claude Nabers and D r . James O ' B a n n o n .
For further information write to the register: The L . D . Pankey
Institute, Suite 302, Dupont Plaza Center, 300 Biscayne Boulevard
W a y , M i a m i , F l a . 33131.

WASHINGTON UNIVERSITY SCHOOL O F

DENTAL MEDICINE
Washington University School of Dental Medicine is seeking
applications for Chairperson, Department of Periodontics. A p p l i cants should have graduate training i n periodontics and should be
boarded or board eligible. Some teaching and research experience is
preferred. Submit curriculum vitae to D r . Peter A . P u l l o n , Washington University School of Dental M e d i c i n e , 4559 Scott A v e n u e , St.
L o u i s , M i s s o u r i 63110. A n affirmative action employer.

TEMPLE UNIVERSITY SCHOOL O F DENTISTRY

Temple University School of Dentistry announces the following
Continuing Education courses:
TITLE:
DATES:

Participation Course i n Basic Periodontal Therapy (6

consecutive Wednesdays)
M a r c h 15, 22, 29; A p r i l 5, 12, 19, 1978

F A C U L T Y : D R . D . L I T W A C K , D R . I . A B R A M S and Staff, Department

of Periodontology, Temple University

In addition to the introduction of startling new theories o n
periodontal regeneration, pocket control, and periodontal surgical
procedures, there will be a full day of lecture, lab, and practical
application of occlusal principles. The doctor will treat a selected
patient in initial therapy and basic surgery.
TITLE:
A d u l t T o o t h Movement
DATES:

A p r i l 6, 7, 1978

FACULTY: D R . A L L A N

S C H L O S S B E R G , D . M . D . , M . S . Associate P r o -

fessor, Department of Periodontology, Temple U n i v e r sity School of Dentistry

T o o t h movement is indicated for many adult patients as a part of

UNIVERSITY O F C O L O R A D O SCHOOL O F DENTISTRY

The University of Colorado School of Dentistry announces the
following continuing education course:
TITLE:
Endodontic/Periodontic Refresher Course
DATES:
February 1 3 - 1 6 , 1978
L O C A T I O N : K e y s t o n e Resort, C i l l o n , C o l o .
F A C U L T Y : R O B E R T E . A V E R B A C H , D . D . S . , C h a i r m a n of E n d o d o n -

tics, University of Colorado School of Dentistry

R I C H A R D B . C H A F F E E , J R . , D . D . S . , C h a i r m a n of P e r i o -

dontics, University of Colorado School of Dentistry

M A R V I N A . G R O S S , D . D . S . , Associate Clinical Professor
of Endodontology, Temple University School of D e n tistry
L E S L I E M . S A L K I N , D . D . S . , Associate Professor of Periodontology, Temple University School of Dentistry

their comprehensive dental treatment. The course will consist of

lectures, demonstrations, and lab sessions.

This course will provide an update for both the generalist and the
specialist i n the fields of Endodontics and Periodontics. Emphasis
will be placed on current concepts of diagnosis, treatment planning
and clinical therapy.

For further information contact: Office of Continuing E d u c a t i o n ,

Temple University School of Dentistry, 3223 N . B r o a d S t . , P h i l a .
P A 19140 (215)221-2955.

For further information contact: M r s . R u t h G . B u s h , Director of

Continuing E d u c a t i o n , University of Colorado School of Dentistry,
C 2 8 4 , 4200 E . Ninth A v e . , D e n v e r , C O 80262.