Background: Pulpectomy is a widely performed procedure for preserving primary teeth affected by irreversible pulpitis or pulpal necrosis until their physiological exfoliation. The quality of obturation is a key determinant of treatment success, and the presence of voids within the obturating material or at the material–dentin interface can compromise the hermetic seal, leading to bacterial leakage and potential treatment failure.

Objective: To provide a comprehensive overview of the etiology, classification, evaluation, clinical significance, prevention, and management of obturation voids in primary teeth, while highlighting recent advances in obturation materials, techniques, and assessment methods.

Review: A narrative review of the literature was conducted using electronic databases, including PubMed, Scopus, Google Scholar, and Web of Science. Relevant studies on obturation quality, void formation, obturation materials, delivery techniques, and imaging modalities in primary teeth were reviewed. Current evidence indicates that void formation is influenced by root canal anatomy, operator technique, instrumentation, material properties, and obturation methods. Advances in syringe-based delivery systems, improved obturation materials, and three-dimensional imaging techniques such as cone-beam computed tomography (CBCT)^5-12 and micro-computed tomography (micro-CT) have enhanced obturation quality and the detection of voids. Comprehensive assessment systems, including the Coll and Sadrian criteria2, KEDOO Classification3, and the SS Radiographic Evaluation Checklist, have further improved the evaluation of obturation quality.