Page 8 - The Beauty and Sorrow in Endodontics-Chapter 1

Chapter 1

Adhere to the Strict Treatment Philosophy of

Schilderian Endodontics

By the end of this chapter, you should be able to answer the following questions:
1. What is the material that seals the lateral and accessory canals when using warm

vertical compaction technique? Is it the same substance that is used to fill the main
canals?
2. What is the difference between a dense overfill and a non-dense overextension, and
why is overfilling encouraged in Dr. Schilder’s obturation technique?
3. In the event of a previous failed root canal treatment, how do we decide whether to

dive straight in for an apicoectomy or take a more conservative route and complete
non-surgical root canal retreatment? What are the guidelines and criteria in
selecting either treatment?

Dr. Schilder’s Treatment Philosophy

A tooth without pulpal tissue can still function as long as it meets the
following criteria: 1) a healthy attachment apparatus, 2) a properly cleaned, shaped,

and obturated root canal system, and 3) an appropriately restored cavity access. The
success or failure of a root canal treatment in part depends on the operator experience
and cooperation from the patient. Dr. Schilder believed that the health of the

attachment apparatus of a tooth (cementum, periodontal ligament, and alveolar bone)
is as important as the health of the pulpal structures within. Therefore, before initiating
any root canal treatment, a dentist must evaluate the periodontal status of said tooth. If
periodontal disease is present, we must consider whether a simple non-surgical
treatment or a combined non-surgical/surgical treatment can be successfully

implemented to restore its periodontal health. In other words, as long as a healthy
attachment apparatus is present around the tooth, dentists can achieve predictably
successful root canal treatment and preserve the tooth by properly cleaning, shaping,

and obturating the root canal system.

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