Oral Health Group

Illogical Logic of Dangerous Dichotomies


http://www.slideshare.net/kendo160/wave-one-jan2012

http://www.slideshare.net/kendo160/dentinal-tubule-infection-as-the-cause-of-recurrent-disease-and-late-endodontic-treatment-failure-a-case-report-12270277

If you read both these articles, you have to be left with a sense of the “dangerous dichotomies” in their relative perspective. If one were to consider all possibilities suggested “in a step by step linear manner” and then formulate a solution that is best for all contingencies, you are left with a disparate fait acompli whose rationale makes no sense unless considered within the context of an skewed ideology. Logic has become merely the latest casualty in our profession’s rush to expedite product launches based upon unsubstantiated, flawed, fallaciously multi-variate, suggestive, solipsistic publications.

 

 

 

 

 

 

 

 

If you review the first paper, you cannot help but sense a defensive tone from the outset…”as with anything new, immediate opinions are given, frequently without knowledge, understanding or experience” – interesting, however, given the “system” being proposed, other than in articles by the “team of clinicians”, there are no retrospective longitudinal studies on well defined treatment outcome studies. Science is not established by market driven copywritten bullet points about how a so called non-panacea is in fact a panacea (subliminal juxtaposition).  Shape is not the defining parameter of successful root canal therapy; neither are mated points, cones, or carrier based obturators. The graphics are impressive, however, the ones showing centering ability could just as easily be entitled Hyflex, Typhoon or RaCe or many of the other 60 systems in the marketplace. The illogical logic is that a file system is the sine qua non of endodontic success. If you preach that long enough, pervasively enough, throw enough money at propagating a single variable of a highly complex and interdependent scientific procedure, then the team opinion with its endless repetition becomes expert through eminent domain………not truth, just opinion with no scientific substantiation.

I encourage you to read the second study…..references are relevant and meaningful and “non-aligned”.  There is histology to validate and substantiate the hypothesis; endodontic success requires debridement and disinfection – shape is a contributing factor, but not the definitive vector in a successful treatment outcome. The point of the second article includes the direct involvement of sealers, irrigants, the myriad complexities of the root canal system and if read on its face, the obvious conclusion is that elimination of microflora in conjunction with ensuring that the residual microflora inoculum is negligible is the de facto raison d’etre for success….the look, the shape is an irrelevancy.  It has marketing value, however, it in no way addresses the “ROOT CAUSE” of endodontic, pulpal and peri-apical disease or the refractory potential. The same can be said for any product or technique that fails to address the single most common vector of any disease – microflora – SHAPE does not eliminate disease. If you seek to  proselytize, then do so with the endgame of debridement and disinfection in mind, not some vainglorious attempt at “SIMPLICITY” and perhaps, and then and only then will a true hearing and collegial evaluation will be in order. But approach it like a used car salesperson and it should be given the obvious credo; fool me once, shame on you, twice and shame on me. You can’t have it every which way but truth.

YOUR COMMENTS are welcome, expected and important.

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