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Chapter 1
Introduction to endodontology
John Whitworth, Lise-Lotte Kirkevang, and Lars Bjørndal
Endodontology
The word “endodontology” derives from the Greek lan-
guage and can be translated as “the knowledge of what
is inside the tooth.” Thus, endodontology concerns all
structures and processes within the tooth, with particu-
lar reference to the dental pulp and the space it occupies.
But what about “knowledge”? What does it actually
mean to “know” things? Most people would probably
say that knowledge has something to do with truth
and being able to provide reasons for things. It is often
believed that dental and medical knowledge is simply
scientifc knowledge – truth that is supported by scien-
tifc research to provide reasons for disease processes
and justifcation for clinical actions. But as practicing
dentists, scientifc knowledge is not always suffcient,
and although it is important to know about the anatomy
of the pulp space and the fatigue failure of engine-driven
endodontic fles, we must also develop sound judgment
and the ability to make correct clinical decisions, often
in the face of uncertainty. The knowledge required by
dental practitioners is therefore complex and multi-
dimensional and can be considered within Aristotle’s
domains of “episteme,” “techne,” and “phronesis” [1].
Episteme
Episteme is the word for theoretical, scientifcally sup-
ported knowledge, the opposite being doxa, which
refers to common beliefs or opinions that may not be
so grounded in “hard” evidence. The body of epistemic
knowledge in endodontology is enormous, spanning
from fundamental pulp biology to the clinical risk
factors associated with root canal treatment failure.
The knowledge generated by science, however, is often
less certain than we would wish, and subject to the
weakness of study design, the bias of conficting inter-
ests, and a lack of obvious translation to the realities of
“wet-fngered” dentistry. Nevertheless, efforts are made
to present scientifc knowledge in a balanced way
through lectures, articles, and textbooks, so from a
student’s point of view, learning requires ample time for
reading and opportunities for discussion and refection.
This book, in large part, is composed of epistemic
knowledge.
Techne
A substantial element of learning endodontology must
be characterized as techne, or “knowing how,” which
embraces elements of practical skill, craft, and artistry.
It is not always possible to explain every detail of how
we perform technical acts, such as negotiating a chal-
lenging root canal with delicate tactile sense or riding a
bicycle around a corner without falling off. In this way,
it is not suffcient to teach students how to shape a root
canal solely by asking them to read a book or attend a
lecture. Their knowledge must be supplemented with
practical experiences, both observing and doing, and by
discussion and personal refection to understand the
challenges they encounter, develop cognitive and prac-
tical strategies to overcome them, and to help them do
better next time.
It is not possible to learn all about the procedures
in endodontology by studying a textbook. Observing a
good clinical instructor, watching other dentists at work,
performing the procedures oneself, and refecting on
what has been learnt are all important. The preclini-
cal simulation laboratory provides an essential environ-
ment in which to embed new factual knowledge and
translate it into practical reality.
Phronesis
According to Aristotle, phronesis is the ability to think
about practical matters and then acquire the ability to act
Textbook of Endodontology, Third Edition. Edited by Lars Bjørndal, Lise-Lotte Kirkevang, and John Whitworth.
© 2018 John Wiley & Sons Ltd. Published 2018 by John Wiley & Sons Ltd.
Companion Website: www.wiley.com/go/bjorndal/endodontology
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