What Are The Benefits Of Collegial Debates?

First, what is prevented in collegial debates? Personally degrading remarks that stereotype individuals with the loss of appreciating the array of motivations that guide a person’s actions. Such stereotyping is done to render a simplified version of the whole person and far worse than that is the intentional goal of making that simplified person representative of evil without any specific data that validates those assumed characterizations. If one is going to characterize someone as an individual limited to his own personal financial gain, the accuser has the obligation to prove that what the accused is saying is without merit, that they are lies and the claims made for the superior performance and safety of alternative techniques has no basis in reality. If that cannot be clearly made, the process is degradation without merit.

Example: Stainless steel relieved twisted reamers confined to short arcs of motion are clearly invulnerable to separation. Even the individual degrading the messenger (me) admits that attribute. So, he cannot legitimately undermine my character by espousing a truth. He may say with the improvements in NiTi metallurgy that NiTi is no longer much of a problem, but an examination of the current literature and incidences of instrument separation on social media make that a subject of unresolved debate.

Example: He states that the cases I post with curved canals that are apparently free of distortions have been Photoshopped implying terrible things about my character. I responded by saying he must be impressed by the posted work, but his attribution that such results could only be attained by corrupt manipulation is a wishful thought of his own mind and has no basis in fact. I assume those in the know have the means to tell if any manipulation has occurred and I encourage him to seek such talents.

Example: This same individual states I should send him sets of our instruments to be tested in a school he is evidently affiliated with. For a person who has already displayed crude language in assessing my character to have trust in his offer would be beyond naive. It also makes me curious that a person who has already displayed such behavior would even think he could make an offer that would not immediately be dismissed. The basis for any ongoing relationship must be built on trust, something he trashed from the start.

Under any circumstances, the big advantages of the 30º oscillating stainless steel relieved reamers have already been confirmed in the literature and videos illustrating their actions in complex pulpal anatomy. These documented advantages include non-breakage, superior cleansing due to their vigorous application against all canal walls, non-distortion from the many posted cases and consistent with the principles established by the balanced force technique. Other factors, not nearly as noticeable , include a reduction in the production of dentinal micro-cracks, the reduction in impacted debris that too often results in the loss of length as the glide path is created using K-files manually rather than the stainless steel relieved reamers in the 30º oscillating handpiece at 3000-4000 cycles per minute.

One can certainly take a position favorable to rotary NiTi and that is one that should be the basis of a collegial debate without any self-perceived opinions as to what a person’s motivations are in taking those stances. For sure, rotary NiTi offers advantages over the manual use of K-files in terms of a reduction in hand fatigue and a reduction in procedural time requirements. The more specific and relevant comparison to make today is between the dominant use of rotary NiTi compared to the use of relieved stainless steel relieved reamers in a 30º oscillating handpiece at 3000-4000 cycles per minute. This should be a collegial debate devoid of personal remarks.

In that regard, there is one more example where this individual takes liberties beyond an acceptable level, namely, his criticism of me because I reference the JADA study that concluded that 80% of academic endodontists are the recipients of industrial payments. He defines my referencing this study as an insult to all academia. That is perverse. I quote a study in the official journal of the ADA that documents this reality, something that should be a concern to all of us and a major wakeup call and his only conclusion is that it is a gross disservice to all that teach. In his view, this form of corporate influence should be left unmentioned, never see the light of day because evidently in his mind, there is nothing wrong in its occurrence.

So, concerning the results of certain studies that conclude rotary NiTi is superior in debridement and non-distortion when comparing the two approaches, a case can be made that the results defy empirical logic and even if true have no proven impact on outcomes unlike the one factor, the separation of a rotary instrument in a non-vital tooth with a periapical area that is proven to negatively impact success rates. This whole area of debate has been muddied by the documented evidence that clearly demonstrates that a large portion of academic endodontists are the subject of corporate payments with the greatest amounts going to those the industry considers the known opinion leaders.

It is not slander when it is true and I have done my best to avoid personal accusations. However, any person who sees the benefits of academic decisions made free of corporate influence knows this is a subject that is important to embrace and do whatever they can do to see it eliminated. To so irresponsibly accuse others of behavior that transgresses the most basic of norms and to do it so flagrantly without any hint of proof pollutes learning platforms like linkedin that provide opportunity for the voicing of alternative methods weakens one of the strengths of our technological age and we should all be aware what is being damaged when this form of behavior is aired and then tolerated. It’s passive approval sends a message that hurts all of us in the long run. To reiterate, nothing hurts an open forum where all points of view regarding the details of various techniques are discussed in detail unencumbered by personal attacks and willful prejudice.

Regards, Barry