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The evolution of Endodontics and Critical Thinking - Courtesy ROOTS
The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. - www.rxroots.com

From: Benjamin Schein 
To: ROOTS
Sent: Sunday, October 29, 2006 7:18 PM
Subject: [roots]The evolution of Endodontics and Critical Thinking

Rodney: I really am impressed by you; You are a Ďheck of an endodontist not just by the way you accomplish your beautiful work but by the way you reason. But you must recognize endodontists as human beings need to grow. We can't stand still. If we stood still we would still be using the hand tools made of jade by the Mayans over a 1000 years ago, or a device pushing a foot pedal to move a spinning wheel, which in turn moved the handpiece with a cord. Or we would still be locating canals by feel or with the naked eye. Today rotaries are better and more efficient to shape root canals than just hand files. And today thanks to the shape attained with rotaries more dentists are doing a better job of cleaning (debriding or disinfecting) the space where the pulp got sick from caries biofilm or gave way to the bacteria and necrosed. and therfore the canals became colonized and infected. The ďGreat Bleach debateĒ thread ilustrates the fact that in irrigation we are still using very old technology and the need to improve it. Whether due to the brains of Schoefel or Nussbein/Reader, or Lusi or Dovgan this will also go forward. Using new technology in Dentistry is a journey that each one personally can slow down or speed up, but nobody can stop it. If we stop it, we stop the world's progress and evolution, and we need Industry to speed up this evolution as Joey D has found out. But you are right we can not today lessen or downplay the importance of obturation so we will need to fill canals as methodically as possible, so whether we will be using gutta-percha and eugenate sealer or newer materials such as Resilon or Epiphany, or Endo-Rez. we will be using forms of technological advances to first control the infection and second fill the space where the infection ocurred so it does not become infected again. Or perhaps the profession due to great thinkers such as Jim Simon and others will find a way to not need to fill canals by licking the disease known as dental caries, and by stopping the orgies of tooth preparations to fabricate leaky crowns. Still some teeth will be lost due to trauma and the more implants evolve the less need for tooth preps and the less need for endodontics - Ben Schein Hi Ben, Thanks again for your compliments. I must say that one of my weaknesses is my love of newgadgets. And endoís got gadgets galore. Itís safe to say that Iíve bought and tried just about all of them, and for a guy like me it is a wonderful time to be an endodontist with all the new tiny little instruments, pliers, U/S tips, rotary designs etc that have been developed in the last 10 or 15 years. You should see me at the convention. Iím like a kid in a candy store and the reps can see me coming a mile away. :-))) In all honesty, the one thing Iím convinced Iíve seen over the last decade with all of the great advancements in endo is a decrease in the quality of many root canal treatments and quite possibly overall success rates. Particularly among those who are doing the majority of the nations endodontic treatments the general dentists. My percentage of retreatment has increased significantly as more and more practitioners are tackling complex molars. In my opinion, these new products, particularly rotary NiTiís, are being marketed to the masses as a new, improved, faster, better way to do a root canal with little or no attention being directed toward the biological principles and anatomic complexities of root canal systems, which are far more pertinent to endodontic success than the pretty white stripes. Perhaps in the future there will be a simple way to do predictable endodontics. Canal sterilization, perfect hermetic seals, zap it with a laser or introduce good bacteria to destroy the nasty anaerobes and their endotoxin. Who knows? Until then . . . . . . . I wonder if the Mayans were pre-bending their hand instruments. :-))) - Rod So very true. But, Rod, it is now the age of quick and easy...money. You'll see the same happening with implants when the number of weekend wonders explodes with those who exploit a discipline to line their own pockets. I was absolutely amazed at the number of people who defended the promoter of 15 minute molar endo to the point of belligerent and angry attacks when he was challenged. Barry may be here but out of all his promotional posts for his technique with SafeSiders I don't remember the last time I saw him mention irrigants and disinfection of the canal. Yes, it is a sad state of affairs and I plan on addressing it in my article for my district. Sad. Guy

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