Page 15 - The Beauty and Sorrow in Endodontics-Introduction

Difficulty in Treatment Resulting from Complex Root Canal Systems

Over the years, anatomical studies of teeth have confirmed the presence of complex
and variable root canal systems. In fact, the entire root canal system is comparable to a
tree – in addition to many lateral canals branching off a main trunk (main canal), even
more tortuous and finer accessory canals can be found near the apices. Dentists who

claim that root canal treatments have unpredictable results are usually the ones that are
fearful of its complexity or have failed to follow the strict treatment protocol.

Treatment Principles

In general, even with the aid of a microscope, one might still run into trouble during
root canal treatment. This is largely due to the fact that the deepest parts of the root canal
system are often spaces that cannot be visualized. However, it is exactly this complex

system that can easily be infected, therefore, regardless of the methods used to clean the
infected canals, the goal is to be able to completely shape and debride the canals in order
to obturate the space and seal off any exit portals to the surrounding structures.

Schilderian Technique

Dr. Herbert Schilder from Boston University is one of the greatest pioneers of three-
dimensional obturation in modern endodontics. His unique envelope of motion for

cleaning and shaping and his persistence on precise verification of working lengths
throughout treatment results in treated canals that maintain its original flow with no
transportation in the apices. If the warm vertical compaction technique that Dr. Schilder

advocated is utilized, then one can expect three-dimensional filling of the root canal
system, its lateral canals, and all its portals of exit with warmed gutta percha and sealer
puffs.

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