Reviewed by Dr.
Robyn Thomas 11 on pathology which details the
60 Park Street
Sydney 2000
Pathways Of The Pulp (4th Ed)
By: Stephen Cohen and
Richard Burns (Eds).
Published by: Mosby, 1987
Format: 818 pages
Available from: CIG Medishield,
11 Khartoum Rd, Nth Ryde, 2113.
Price: 5128.75
Notwithstanding the author's
over patriotic dedication of this
publication to all that is good in
America, this 4th Edition of Path-
ways of the Pulp is an excellent
text for all students of endodontics
in Australia - graduates and under-
graduates alike.
Released just three years after
the 3rd Edition this new book has
been produced with the assistance
of 36 contributors selected from all
regions of the United States.
Although proclaimed in the
preface as virtually a new book
with 22 of the 26 chapters com-
pletely rewritten or significantly
revised and with many new faces
in the list of contributors, the
changes were not as great as
expected. In fact even the last
chapter on the future of endodon-
tics is identical to that in the 3rd
Edition except for a timely warning
for all dentists not to let high
technology replace tactile sense
and common sense.
Most of the chapters which
have been revised have been
improved. Chapter 3 o n case
selection and treatment planning
is much better organized and
Chapter 7 on cleaning and shaping
the root canal includes a more
comprehensive review of the liter-
ature and presents a greater variety
of preparation techniques than in
Edition 3.
Chapter 10 and 14 on pulpal
structureand function, and reaction
to caries and dental procedures
have benefitted from the contribu-
tion of Syngcuk Kim. The chapters
are very well written, easy to read
and include practical clinical appli-
cations. A new section in Chapter
review of the effects of instrumen-
characteristicsof acute inflammation
and chronic inflammation is very
interesting reading for those who
want to brush up on their basic
pathology.
One of the main areas of
revision in this edition is in the
description of the instruments and
materials, and in Chapter 13 there
has been added a whole section
on developments in endodontic
instruments, materials and devices.
This is a good review of recent
developments from changes in the
cross-sectional shape of hand files
to the use of sonic and ultrasonic
instrument systems and the new
obturation devices. New materials
such as the calcium hydroxide
containing root canal sealers are
also mentioned.
A more comprehensive section
on sterilization and disinfection
has been included in the new
edition, presumably in response to
the attention given to AIDS and
Hepatitis B in recent years. In
addition, the sample medical history
sheets have been expanded to
include questions on AIDS and
drug and alcohol addictions. The
importance placed on asepsis and
prevention of cross-infection is
carried through to the illustrations
with almost all clinical photographs
showing gloved hands.
With any large textbook com-
prised of chapters written by
different contributors there is likely
to be overlapping between chap-
ters and sometimes not enough
cross-referencingbetween chapters.
This text has not escaped the
problem. For example, it would
have been helpful if the chapter on
bleaching had referred to the
chapter on resorption in which
cervical external resorption as a
possible sequelae of bleaching was
discussed.
In a couple of instances inter-
esting sections have been poorly
placed in the text and inadequately
indexed. For instance in Chapter 12
there is an extensive and interesting
tation beyond the apex on the
incidence of clinical "flare-ups",
and on the possibility of repair.
Unfortunately, it is under the sub-
heading septicaemia with which it
is only tenuously linked.
I was disappointed with the
limited amount of information on
periapical pathology especially
cysts and lesions of non-pulpal
origin as these are very important
in differential diagnosis. I also
missed the chapter on orthodontic-
endodontic treatment, which was
included in the 3rd Edition, espe-
cially the section on orthodontic
extrusion of teeth.
In general this text compares
favourably to the 3rd Edition of
Ingle's Endodontics which has
become the standardagainst which
other comprehensive texts are
compared. Both books provide a
guide to endodontic treatment
which if followed will lead to
successful treatment and the avoi-
dance of most problems.
A recurring feature of editions
of Pathways of the Pulp is the
inclusion of self-assessment ques-
tions at the end of each chapter.
These have been up-dated in the
n e w edition and are a great
teaching and learning aid.
The recommended price of
5128.75 I believe represents good
value for money as it is less expen
- sive than Ingle's Endodontics.
The stated objective of this 4th
Edition of Pathways of the Pulp is
to impart the most current knowl-
edge regarding the art and science
of endodontics and as Samuel
Seltzer, to whom this edition is
dedicated, stated in the introduc-
tion this information has been
masterfully presented.
A.E.N. Vol13 No. 2 1987 11