17/08/2026
Apical puff in endodontics refers to extrusion of sealer, gutta-percha, or both beyond the apical foramen during obturation.
🔹 Is an apical puff always a problem?
No. A small, intentional sealer puff can occur and may not necessarily compromise treatment, particularly when the canal is well cleaned, shaped, and obturated.
However, large extrusion—especially of gutta-percha or sealer into the periapical tissues—can cause inflammation, pain, delayed healing, or nerve-related complications depending on the location and material.
🔹 Important clinical point
A radiographic apical puff does not prove a better seal. The goal should be a well-cleaned, adequately shaped and densely obturated canal ending at the appropriate working length, rather than intentionally pushing material beyond the apex.