![]() ![]() Doctor participant names are listed in reference section. Endodontists invited to the SS White Modern Endodontic Consortium. The distance from the “centroid” to the flange areas of both the tooth and the I-beam determine resistance to bending. Stiffness and resisting to bending are basic engineering principles. Area between the lines should be maintained and is referred to as the soffit. Dotted line shows the typical cut made to remove the entire pulp horn. There are several reasons why an increasing number of clinicians are embracing this concept (Table). This tiny “lip” or “cornice” could be as small as 0.5 mm, or as large as 3.0 mm in some cases (where extra strength is needed, or when the anatomy allows it). Today, when considering endodontic access, a worthwhile goal is to maintain a small border amount of the chamber roof near the point where it curves 90° and becomes the wall. One of the silly rules (taught for decades) is that the entire roof of a chamber needs to be removed during endodontic access or, you are a sloppy and lazy dentist. ![]() The chamber of a young molar tooth is bounded by a roof, 4 walls, and a floor with small orifices that are arranged along the edges of the floor like pockets along a pool table. The Pulp Chamber Soffit In architecture, a soffit is described as the underside of a ceiling, at the corner of the ceiling and wall. In this article, we will discuss the new terms: soffit, pericervical dentin (PCD), orifice enhancement, and dispense with an oft abused term, endodontic shaping, and replace it with endodontic instrumentation. THE NEW LEXICON OF ENDODONTICS As we seek to redesign endodontic access, it is crucial to create a new lexicon (an endodontic dictionary of sorts). They do, however, weaken the tooth badly. 1 To summarize: Big shapes don’t create better outcomes. In a landmark literature review, apical shaping size and canal taper had no significant relation to better outcomes. This machined, man-made shape is referred to as “the look.” This was done without outcome studies that validated this extravagant expenditure of tooth structure. Sacrificing and obliterating massive amounts of tooth structure is in vogue today. Most troubling has been the recent shaping change grotesque straight-line access, carving a superhighway to the apex. Endodontists have instead been very apex-centric in their focus of endodontic shaping. Black style accesses that endodontists inherited remain largely unchanged. Interestingly, the cavosurface portion of G. From that point on, endodontists were essentially handed the keys to the kingdom, and were charged with endodontic shaping design. Why Does Endo Access Remain in the Dark Ages? Endodontics was first recognized as a specialty by the ADA in 1963. Covers of Contemporary Cavity Preparations and Contemporary Endodontic Access textbooks (soon to be published). As a restorative dentist, these hollowed-out teeth seen in the radiographs should elicit an immediate visceral response nervous about any hope for longevity, and a sick feeling for the tooth and the patient. Somehow pleasing to the eyes of many endodontists, these pre-op and post-op radiographs demonstrate the “superhighway to the apex” philosophy. Upper and lower incisors badly gouged by round burs exacerbated by cingulum access. This article will contain excerpts from the upcoming textbook. SS White Burs president, Tom Gallup, has made a generous donation to begin a new textbook, Contemporary Endodontic Access (Figures 3 and 4). In contrast, dentin and enamel have no advocates, no budget, and no slick advertising campaigns. ![]() When billions are at stake, change happens. Witness the incredible advance in implants. Similar to outdated restorative cavity preparations, there are scant resources to devote to the monumental task of changing the way that we cut teeth. Whether gouged by general dentists (Figure 1) or “gutted” by endodontists (Figure 2), the damage is seemingly everywhere and it is irreversible. ![]() There are several impediments that have stopped progress and left endodontic access in the dark ages. Black cavity preparations that remain the current standard? Sadly, yes. INTRODUCTION Are today’s typical endodontic accesses as outdated as the typical G. ![]()
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