Australian Dental Journal, October, I 9 7 2 353

An evaluation of Schilder's endodontic technique

A. Langford, B.D.Sc(Melb.), D.D.S.(Tor.), F.D.S.R.C.S.(Eng.& Edin.), F.A.C.D.S.,

and P. J. Cunnlngham, M.D.Sc.(Melb.), D.D.S.(Tor.), F.A.C.D.S.

Introduction Vertical condensation with warm gutta percha

It is the dosired objective of endodontic treatment As stated earlier, the object of any endodontic
that the root canal space be completely obliterated procedure should be the complete obturation of the
in all dimensions. To satisfy the biological prin- root canal system.
ciples, the root canal system must be freed of
Single cone techniques using either gutta percha
potential irritants, namely protein degradation
or silver points do not achieve these objectives.
products, bacteria and bacterial toxins which may
Moreover, laterally condensed gutta perch8 is
arise from necrotic pulpal tissue. It is true that
basically a single cone technique. It is only by
these conditions may be satisfied by extraction of
using warm y t t a percha with vertical condensation
the offending tooth. However, it is more desirable
that greater density may be created on the apical
to retain the tooth and preserve the integrity of the
portion of the filling as well as obliterating accessory
dental arch. The root canal system can be rendered
canals and foramina.
innocuous to the bone just as effectively as if the
tooth were extracted by removal of all substrate and Schilder has designed instruments of different
total obliteration of the system. lengths and diameter for this technique (Fig. 2).
The instruments consist of one heat carrier
Access (Fig. 3) (identical to a number three spreader) and
I n order to employ the Schilder technique a series of pluggers whose sizes have been carefully
successfully, instruments are used whose rigidity
demands that straight line access be obtained. If
these requirements are not followed, inadequate
cleaning and shaping of the root canals may result,,
sterilization of tho canal cannot be obtained, and
complete three-dimensional filling of the root canal
is impossible. However, this does not mean that
gross destruction of the coronal tissue is necessary
(Fig. 1).

Biomechanical instrumentation
No root canal is regular in its shape. Variations
in the internal anatomy present to the endodontist
a n irregular tube filled with organic material and
i t is essential to clean, sterilize, and create in this
tube a continuously tapering funnel with its greatest
dimensions at the coronal access and its least
dimension at the apical foramen. It is not Fig. l . - C a v i t y prepared to provide straight-line access to
the root canitls, without gross destruction of coronal
imperative whether the operator selects reamers or substance.
files for his instrumentation. The method is to open
the canal to a number three reamer or file to the graduated to coincide with the reamers and files
radiographic apex and then progressively reduce
used during biomechanical preparation. I t is
the working length by one millimetre with increase
imperative in selecting the trial point that a gutta
in size of reamer or file until the canal has been
percha cone be chosen whose taper is longer than
widened to a number eight in the coronal section.
that of a root canal. This cone should bind only
in the apical portion of the canal and demonst,rate
Received for publication January, 1972. tug back and coincide with the radiographic apex.
354
One to two millimotres is then cut from the tip
of this cone to allow for some apical movement
during vertical condensation. The canal wall is
Fig. 5.--Esaniples of long pluggen for vertical condcnsat ion
of w m i i putts perch%.
Fig. 3.-Plugaer and heat carrier. Note blunt end of
plugger and lines etched at 5 mni intervals to facilitate
assessment of condensation.
lightly coated with the Healer of choice and tEe
gutta percha cone is slowly seated into the canal.
The excess gutta percha is removed from the access
cavity with a hot instrument and the warm coronal
portion is forced down with a larpe plugger from the
Schilder series. Kest the heat carrier is heated to
red heat and inserted into the gutta percha within
the canal. This is immediately followed hy a
Australian Dental Journal, October. I972
plugger of suitable size which forces the gutta percha
both vertically towards the apex as well as laterally.
The function of the heat carrier is twofold, both to
soften the gutta, percha and to remove excess gutta
percha from the canal. The procedure is repeated
until the apical portion of the gutta percha has
been moved to coincide with the radiographic apex.
Now the root canal is essentially empty except for
its apical end. To fill this remaining portion small
pieces of gutta percha two to four millimetres in
length are selected, warmed, and condensed to
complete the obliteration of the root canal system
in all cases (Figs. 4, 5).
Fig. 4.-Canal in lower second hiriispid obtursted with
wiiriii gutta perchn. Note accessory cnnslx.
Big. h.-Dil:icerated apes of lower second bicuspid. Root
canal has been successfully obtursted with warni gutta
percha.
Summary
A technique for endodontic treatment devised by
Schilder has been described. When this technique
is employed the root canal system will no longer
be a source of irritation to the bone and a lesion
of endodontic origin will heal just as completely
as if the tooth had been extracted.
147 Collins Street,
Melbourne, Vie. 3000.