March 3, 2011
Lorraine Daston and Katharine Park; two eminent historians who write on the subject of scientific claims note that in the days prior to enlightenment, “the hallmark of the narrow-minded and suspicious peasant, trapped in the bubble of his limited experience” was a comment directed at those who challenged “eye-witness” testimony or as we know it today, the claims of advertisers and manufacturers about new and “revolutionary” products. The title of this blog entry translates as the Second Coming of Endodontics; Don’t take anyone’s word for it.
I am an endodontist, my circle of knowledge ranges within that sphere, however, it doesn’t take a seer to see how the winds of change are blowing along the canyons of the dental landscape. In endodontics, the forces at work seem to be directed towards a simplistic one file, carrier based obturation approach to a biologic complexity that has been visualized and understood some 90 years ago and then reinvestigated and re-imaged with microCT analysis and cone beam tomography today and yet, they are being hailed as innovations and game changers.
For your frame of reference please refer to twitpic and then to Dr. Martin Levin’s webinar.
Then please review the commentary and images below for your consideration. The objective is simple……can you relate what is being described and marketed with what is understood, accepted and has been show to require tactile and technical skill and precision that requires years of training and experience…..are we in dentistry being reduced to weekend courses, copywriting hyperbole and share prices in lieu of longitudinal retrospective studies and evidenced based meta-analysis……….your input and comments are invaluable.
The great virtue of mathematics is that its truths alone are certain
and inevitable; in any universe, the shortest distance between two points is a
straight line. And yet, the pundits of the new wave in endodontics would have
us believe that single files regardless of their envelope of motion, be it
recipricating, rotary or piston-like, can effectively debride the negative
space of the root canal system in defiance of the morphometrics and myriad
complexities of the inner world of teeth. Similarily, insubordinate to the
science of rheology, carrier based obturation is deemed equivalent to the force
generation and resultant gravitometrics of injection molded warm thermolabile
techniques as described initially by Blaney and made mainstream by Schilder.