N2: Mark Piacine

Why Are They So Stubborn?
American Endodontic Society President’s Message – December 2007
by Dr. Mark Piacine


Bob Khodadadeh, from his Mastership acceptance speech, several years ago, “WHY ARE THEY SO STUBBORN?” After presenting his hundred or more exemplary successful required cases, he was referring, of course, to the Endodontic Specialty Group in this country, who are sanctioned by the American Dental Association as the so- called experts in root canal treatment. Despite the fact that Sargenti Endodontics is successfully practiced and preferred in most of the rest of the world, they continue to ignore our superior method and discredit our existence. They just “don’t get it”. Actually they just don’t want to “get it”.
The facts are there. Dr. Angelo Sargenti devised this revolutionary treatment in his home country of Switzerland back in the 1940's (almost 60 years ago!!) After introducing this method to American dentistry at the ADA Annual Meeting in Dallas in 1958, because of its simplicity and phenomenal success rate with virtually no discomfort, it spread like wildfire throughout the nation. Every general practitioner could now perform his own root canal treatment and with no pain! Dr. Sargenti’s innovative genius introduced canal cleansing with mechanical instrumentation, rather than hand manipulation. WOW! In addition, the process could most often be completed in just one visit. UNHEARD OF! But what about culturing of the canal? Unnecessary, said Dr. Sargenti, for his newly developed sealer that included the optimal just 4% Formaldehyde automatically destroyed 99.9% of all the bacteria in all the intersticies of the root canal “system”.

A MIRACLE! Arrive on the scene, Dr. Alvin Arzt, who brought this technique into his own practice, and through trans-Atlantic personal correspondence with Sargenti and actual visits to Europe, in 1969 organized what is now the American Endodontic Society. This organization immediately grew, and soon, aided by Drs. Joseph Venneri, Ramon Werts and James Gary presented instructional courses all across the country.
WHOA!! A root canal treatment that was so simple and successful that it could be treated in just one visit by a General Dentist? The Endodontic Specialists, for fear of their own existence, soon sprang into action to discredit this new treatment. A program of half truths and innuendo was instituted. “It was borne by a Swiss Dentist who could only speak broken English”; and the technique was sloppy and did not properly cleanse the canals. In truth, Dr. Sargenti was a brilliant scientist, who, when he came to this country for the first time did have trouble speaking our language. But he soon conquered this deficiency and from lecturing all over the world, soon became fluent in five different languages. It’s right from the debating playbook: If you can’t attack the message, attack the messenger.
He personally related to me that he had “crossed the Atlantic” 42 times in his quest to “save teeth from the extraction bucket.” As for it being a “sloppy” technique, we all know that this method employs strict canal cleansing,
the same as other methods. What we don’t do, is use caustic lavages such as Sodium Hypoclorite. But worst of all, junk-science experiments were designed to cast doubt among users of the sealer. The most misleading of these would-be-bona-fide reports involved placing a “plug” of Sargenti sealer (N2) sub-gingivally in a laboratory rat’s neck and attempting to demonstrate that the formaldehyde in the plug traveled throughout the rat’s body to the brain, kidneys, liver and other vital organs. FALSE! 

Prominent toxicologist, Dr. Jeffrey Brent, an expert in Formaldehyde, in sworn deposition, tells us that this notion is simply not true. First of all, the formaldehyde, at a mere 4% is not free to move about the body, Dental Anatomy 101. It is locked inside a tooth with no blood supply to exit. Secondly, Brent says that if Formaldehyde would enter the bloodstream, it is broken down in 90 seconds into carbon and water. What was seen in the rat experiments were isotopes of the formalin and not formaldehyde itself. So, he says, “Systemic illness from this treatment is implausible it just can’t happen”. In addition, he reports an interesting fact: the human liver produces gobs of formalin every hour and floods it into the bloodstream.

Another intentional misleading statement is that we put “embalming fluid” in patients’ teeth. N2 incorporates 4% formaldehyde, at that percentage a very safe and efficient sterilizing agent. Embalming fluid is 40%! Toxicity is a matter of dosage. Common table salt or even water (yes, H2O!) would be toxic at high concentrations.
A case in point to their continued stubbornness:
Articles written by Endodontists and juried by the ADA appeared in two recent issues of JADA (Journal of the ADA). The first in the Sept. 2007 issue, p.1228, begins by declaring that the secret to Endodontics is root canal system sterilization. And then it goes on to admit that gutta percha has no anti-bacterial properties. Yet gutta percha is the sealant used by the great majority of endodontists! Stubborn???
The second article from the Nov. 2007, p. 1456: This article proclaims they can find no statistical justification for not doing one visit endo. On the other hand, these authors do go so far as to imply perhaps a return to culturing. Hello??!! Stubborn??? You tell me. Did Dr. Sargenti not inform us about these details about canal sterilization and correct the archaic thinking about cultures almost 60 years ago?
So, the factual information is there. They do “get it”. It has merely been a Sargenti bashing program that has gone on for more than 50 years and tell a lie loud enough and often enough, and it soon becomes fact. Or, at least, sounds like fact. They just prefer to remain stubborn.

But you, my friends and compatriots, know the facts. And I appreciate your helping us to distribute the truth, and dispel the lies. Thank you for your continued support to our organization.