Page 9 - The Beauty and Sorrow in Endodontics-Chapter 1

There is No Need of Pulpal Tissue Once Root Development is

Completed and Adequate Dentinal Thickness is Present

Root canal treatment is not necessary in stages of hyperemia or reversible
pulpitis. However, if the condition is prolonged or progresses to irreversible pulpitis,

then intervention is required. Dr. Schilder believed the pulp provides guidance for root
development, and once that is completed and adequate dentinal wall thickness is
achieved, any diseased pulpal tissue should be removed. Since the pulp is confined in

a small space, inflammatory response does not play in its favour for healing. Even
minute irritation to the pulp will initiate formation of tertiary or reparative dentin,
which further limits the space available in the pulp chamber and canals. These
calcified canals then become obstacles that increase the treatment difficulty when it
becomes inevitable.

Identify Lesions of Endodontic Origin

It is well known that Schilderian Endodontics places special emphasis on the
“root canal system”. The internal cavity of a tooth does not only encompass the main
canals, but also many accessory canals. The portals of exit of these canals exist along
all parts of the root surface instead of limited to the apex that most dentists focus on.
Lesions of endodontic origins (LEOs) are lesions around roots that are the results of

bacteria and its toxins infecting the pulpal tissue, which ultimately damages the
cementum, PDL, and bone where the canals exit. Since these lesions originated from
within the pulp, healing can be expected after proper cleaning, shaping, and

disinfection of the canal systems along with obturation and achieving complete apical
and coronal seal. However, in lesions of other etiology, no endodontic treatment is
required, and treatment should be aimed at eliminating the source of infection.

Strictly Follow the Guidelines and Techniques to Reach a Nice Post-

Operative Image

It should be noted that a nice looking post-operative radiograph only shows
that the previous canal debridement and shaping are adequate. We can only hope that
by using sufficient amounts of disinfecting solution (sodium hypochlorite) in the
correct concentration, with enough time and aid from ultrasonic devices, that it has
successfully disinfected the root canal system. This opens and prepares the main

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