Dentaltown May 2017 - 76

ENDODONTIC
REBOOT
A na
tomic
ally D

by Drs. Gilberto Debelian,
Kenneth S. Serota
and Martin Trope
Dr. Gilberto Debelian received
his DDS degree in 1987. In 1989,
he completed the post-graduate
program in endodontics at the
University of Pennsylvania. In
1997, he received his PhD from
the University of Oslo, Norway.
Debelian now serves as an adjunct
professor at the Department of
Endodontics at UPenn and is in
private practice in Oslo.
Dr. Kenneth S. Serota received
his endodontics certificate and
MMSc degree from the Forsyth
Institute at Harvard. He is on the
editorial boards of Endodontic
Practice and Endo Tribune,
and is the founder of ROOTS
and NEXUS, online educational
forums for those interested
in cutting-edge dentistry.
Dr. Martin Trope received his
BDS degree in dentistry in 1976.
In 1980 he moved to Philadelphia
to specialize in endodontics at
the University of Pennsylvania.
Trope now serves as a clinical
professor in the Department of
Endodontics at UPenn and also is
in private practice.
Drs. Debelian, Serota and Trope are involved with endodontic
education through the training facility Next Level
Endodontics in Philadelphia, which Trope owns.
Information: nextlevelendodontics.com.

76

MAY 2017 // dentaltown.com

Part One

n
o
i
t
c
e
efined Canal Disinf

"The historical sense involves
a perception, not only of the pastness
of the past, but of its presence."
- T.S. Eliot, "Four Quartets"

Introduction
St ud ie s a sse ssing t he d ia met ric
dimensions of apical anatomy repeatedly
demonstrate that the bucco-lingual diameter
is greater than the mesio-distal diameter-
canals are predominantly ovoid throughout,
not round1-4 (Figs. 1a and 1b).
The technical flaw most inherent-the
use of a round file of any design to clean an
ovoid canal configuration-manifests as the
failure to debride a substantial amount of
the canal contents. A recent study showed
that the mean (± standard deviation) of
untreated areas ranged from 59.6 percent
(±14.9, group PT/2) to 79.9 percent (±10.3,
PT/1) for the total canal length and 65.2
percent to 74.7 percent for the apical canal
portion, respectively5 (Fig. 2).
In the 1960s, Dr. Herbert B. Schilder
introduced two legacy concepts to the science

Fig. 1a. This axial view of a mandibular molar
demonstrates the ovoid eccentricity of the canals
and existence of an isthmus connection between
the MB and ML canals consistent with the findings
of numerous studies.8,9

of endodontics: The constricted envelope of
motion for instrumentation (Fig. 3) and the
use of hydraulics to enhance the rheology of
the obturation material used to seal the root
canal space and optimize its gravitometrics.


http://www.nextlevelendodontics.com http://www.dentaltown.com

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