Authors: Grossman LI.
Title: Endodontics: a peep into the past and the future.
Journal: Oral Surg Oral Med Oral Pathol
Date: Apr 1974
Citation: 37(4):599-608
Category: History of Endodontics
Evidence-based Ranking: 5
Discussion: The article describes a half-century of endodontic practice. It was widely believed that the pulp must be “killed” before it can be removed. Arsenic was used and sealed with an exposed pulp and left for 3-4 days to destroy the pulp. Pulps were also removed under pressure anesthesia. Also, anesthetic (Novocain) used to be prepared by placing a Novocain tablet, adding water and boiling the contents over the flame before aspirating into a syringe. Highly irritating caustic chemicals such as sulfuric acid, phenosulfonic acid and hydrochloric acid were used as adjuncts in enlarging root canals. Additionally, chemicals such as formocresol, phenol, camphorated chlorphenol, eugenol and ammoniated silver nitrate solution were used as intracanal medicaments. Pulp mummification was performed by first placing arsenic and then using paraformaldehyde over the dead pulp tissue. Root canals were filled with cotton moistened with creosote, tricresol-formalin, or an essential oil such as Black’s 1,2,3 or oil of cinnamon or cassia. In other cases, canals were filled with gutta-percha and a paste to which thymoliodide was added. Silver cones did not make their first appearance until the 1930’s. The Callahan-Johnston method of filling root canals was popular in the southern part of the country. This was performed by filling the canal with ethyl alcohol, gradually replaced with chloroform, and then gutta percha cones were successively introduced until the milky solution converted into a solid filling. In 1910, Dr. William Hunter in a lecture in Montreal accused the dental profession of contributing to ill health by the kind of dentistry practiced at that time by what is known as the Focal Infection Theory. He lists a long list of diseases which he attributed to oral sepsis from crowns, bridges, denture and dentistry in general. The reaction of the dental profession was the indiscriminate removal of teeth. C.N. Johnson, who later became editor of the JADA, defended root canal treatment. To quote “most pulpless teeth are amenable, and therefore most pulpless teeth may be retained.” Treatment was limited to anterior teeth in the belief that it was too difficult to eliminate infection from posterior teeth. By the 1950’s endodontic treatment had begun to be accepted by the medical profession. Methods of obturating root canals have improved where a slight underfilling within 1mm or so of the apex is desirable and that overfilling is undesirable. Finally advances have also been made in the area of surgical endodontics so that surgery does not mean just root resection but also hemisection, radisectomy, endodontic implants, intentional replantation, transplantation and implantation of teeth.

Reviewer’s comments: This is an article that discusses the history of endodontics.