Page 6 - The Beauty and Sorrow in Endodontics-Chapter 1

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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