Interview: “I saw a lot of improvements in every step of the endodontic treatment”

Dr Cardinali, why did you pick endodontics as your specialty? Where do you see the challenges and the excitement?
After graduating in dentistry, I worked as a dental officer for one year at the Cagliari Military Hospital in Sardinia. At that time, military service was mandatory in Italy. The aim of the military surgery was to manage patients with emergencies. So, from the beginning of my career I started treating many patients with endodontic problems.

Once I had finished my military service, I started working as an assistant in dental clinics where I mainly dealt with endodontic and restorative problems. To improve my knowledge and to better understand the importance of endodontic treatment as part of a multidisciplinary treatment, I started attending the meetings of the Italian Society of Endodontics. At that time, in 1995, the Internet was not as widespread as today and social media did not exist, so the only way to be updated about endodontic techniques and materials was to attend congresses. Being part of the Italian Society of Endodontics had opened up a new world for me. At the beginning, it was a bit frustrating because it seemed like a big challenge to reach the levels of knowledge and skill of the speakers. But, thanks to the Italian Endodontics Society meetings, I obtained the incentives and tools to improve myself over time.

Today, I am very proud to be on the board of the society as treasurer. Basically, in my daily routine, what I do is just to try to save teeth with proper root canal treatments. The challenge with endodontic anatomy is as exciting as it is satisfying to see long-term follow-ups that attest to the validity of our work.

Despite taking place in Korea, do you think that the IFEA congress is important for the international endodontic community? If so, why?
I honestly think that the IFEA congress is really important, because it is a moment of aggregation between all the worldwide endodontic societies. In addition to the pleasure of meeting, and the opportunity to meet, many colleagues from other countries, there is the opportunity to compare, for example, how other endodontic societies face the daily challenges that all societies have today, like maintaining high quality in terms of instruction, how they interact with the scientific societies of other branches of dentistry.

What is the title of the lecture you will be giving at IFEA and what is it about?
My lecture is called “Solutions to simplify shaping and cleaning: Improving the quality of the root canal treatment”. My thoughts are those of an endodontic enthusiast who, like every passionate clinician, tries to increase the success rates of endodontic therapy in the most predictable way possible. Also because my serenity and the quality of my life depends essentially on the satisfaction of my patients.

When I started my practice there were four to five hand files and three to four shaping techniques. Nowadays, the scenario has changed completely and clinicians have access to exceptional tools for endodontic therapy. There is a risk in relying on those very evolved instruments and in thinking that they are more important for a positive treatment outcome than the endodontic knowledge. If any problems occur during instrumentation, such as the separation of an instrument or the creation of a stripping or a ledge, whose fault is it? Is it the fault of the tool or the clinician? What is more important? Tools or technique?

You have been working as an endodontist for many years now. Where do you see the biggest development in the field?
In my 26 years of practising dentistry, I saw a lot of improvements in every step of the endodontic treatment. And what is even more important is that these improvements eased the endodontist’s life and at the same time improved the quality of the therapy. Our lives have changed and our outcome has increased thanks to the introduction of MTA, NiTi rotary files and ultrasonic tips dedicated to endodontics for cleaning, retro preparation in surgery or for the removal of separate files during retreatments.

Nowadays, diagnosis for complex cases is easier thanks to the CBCT. And, what about obturation with the introduction of bioceramic sealers? These are all innovations that a clinician that takes care of patients cannot miss. My workflow and my instruments have changed completely in comparison to the beginning of my practice. The difficult part is to change your own work habits, but when the final results are an improvement of the quality of your professional life and a better outcome for the patient, putting the work in is definitely worth it.

The continuous evolution makes endodontics a branch that certainly is not boring. And this is very exciting for the clinician and I am sure that in the future new techniques and materials will come that will further improve the quality of our treatments.

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