Thursday, November 29, 2018

Blocking progress?


Two decades back when I got a chance to meet the legend in Endodontics Prof. Herbert Schilder during our official visit to the Boston University, my joy knew no bounds. We had a leisurely discussion on Endodontics, exchanged publications. He gave his publication and I gifted him a copy of the dental publication of which I was the editor at that time. 

He told me that he used to be referred to as ‘Enfant Terrible’which means a usually young and successful person who is strikingly unorthodox and innovative.


A Pioneer's work

His article ‘Filling root canals in three dimensions’ was published in the DCNA of November 1967. During that time, we had only stainless instruments and they were rigid. Beyond # 25, each instrument will be transporting the canal. In spite of the knowledge that the apical sizes were always larger than #25, instrumentation with larger instruments beyond this size in severely curved canals was not possible. So it was # 25 that instrumented to the full working length in many curved canals. This Prof. Schilder described as ‘keeping the apical size as small as practical’ and this was due to the rigidity of the instruments.
Then there were two methods of obturation technique that dentists followed. One group used silver points, as a # 25 silver point could be pushed to the working length due to its rigidity (same size gutta percha will buckle and won’t go the full length), and lateral condensation with gutta percah points. The other group followed Schilder’s technique of vertical condensation. Silver point is not the material of choice for obturation as it corrodes with time, and the vertical condensation also had its limitation since the heated gutta percha when cools, there will always be shrinkage. 
We discussed that it will be nice if the apical sizes could be enlarged and cleaned without compromising other parts of the canal system. That he was very much concerned about the cleaning and disinfection is the canal is proven by his colleague, Harold J. Levin, a professor of Endodontics at Boston University, who recalled that Dr. Schilder had stressed the importance of thoroughly cleaning out a tooth's infected interior.


Meeting another Legend


When I had the good fortune to attend a five day Endodontics course by Prof. Steve Senia in San Antonio, Texas  in 2004, I was introduced to the LightSpeed instruments which were non tapered and extremely flexible, which could finally give a biologically optimal apical preparation. Immediately I thought that Prof. Schilder would be happy to incorporate this in root canal treatment. I did not know at that time that he retired from Boston University in 2003.


Another revolution subdued

Prof. Schilder brought a revolution in Endodontics in the 60’s, and I am sure he would have helped to bring in the next revolution when non tapered, extremely flexible root canal rotary instruments became available. That was not to happen, as his health deteriorated in his later years and he died of  Lewy body disease, a brain malady, on 25 January 2006.
Those who admire and respect Prof. Schilder should appreciate he was for the progress of Science and open up their minds. Instead if we just adhere to what he propagated, which was relevant at one point in time, it will be blocking progress!

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