Page 10 - The Beauty and Sorrow in Endodontics-Chapter 1

canals and all existing accessory canals for sealers and warmed gutta percha to be

packed into these spaces. Only when this happens will the post-operative radiograph
reveal the complex and interconnected canals.

In any case, we hope that any debris or infected substances remaining within
the root canal system (even after proper debridement, shaping, and disinfection) will

be either completely blocked within the root canal system, or pushed out. White blood
cells and macrophages can no longer enter the root canal to eliminate bacteria and its
byproducts once pulpal tissue has been removed. In these cases, if a connection is still

present between the bacteria within the root canal and the surrounding structures
outside, these bacteria and its toxins will continue to cause inflammatory reactions in
the attachment apparatus. Dr. Schilder believed that through proper debridement,
cleaning, shaping, and warm vertical compaction of gutta percha, any remaining
pathogens in areas where instruments are unable to reach can be buried completely

within the root canal system or within the sealer, removing any connection of them
and the supporting structures around the root. On the other hand, since the alveolar
bone is rich in blood supply, if the pathogens are pushed out of the canals and into the

bone, the body’s immune system will then have the ability to remove them. Then, as
long as both apical and coronal seals are in place to prevent any leakage, healing will
occur over time.

Regular Follow-Ups are Required After Every Root Canal Completion

Dr. Schilder also emphasized the importance of regular follow-ups (or recalls)
after each case is completed. He believed that by analyzing the healing process and

outcomes of each case, dentists will gain a better understanding of endodontics and
learn to improve their diagnostic abilities and treatment skills. And if a similar case
shows up in the future, they will be more prepared to treat it.

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