Dr. Shaul Lin, DMD is a distinguished expert in Endodontics and Dental Trauma, serving as Chairman of the Endodontics and Dental Trauma Department at the School of Graduate Dentistry and Director of the Post-Graduate Program in Endodontics at Rambam Health Care Campus, Israel. As a faculty member of the Technion’s Faculty of Medicine in Haifa, Israel, Dr. Lin combines his clinical expertise with academic research, focusing on advancements in dental trauma management, root canal disinfection, and preventive approaches in dentistry.
Dr. Lin, it's a pleasure to have the opportunity to chat with you. Your journey in the field of Endodontics is truly remarkable. Let's dive into some questions that I'm sure will offer our readers insights into your expertise and experiences.
Can you share your journey into the field of endodontics with us? What inspired you to specialize in this particular area of dentistry?
I started my journey as a student in general medicine before becoming a dentist because I love doing things with my hands. I like Endo because I can assist patients in getting instant relief for their pain and I have found that I am good at it.
Dr. Lin Shaul DMD is a distinguished expert in Endodontics and Dental Trauma (Image: Dr. Lin Shaul)
What is your overarching mission or goal as an Endodontist? How do you envision contributing to the field globally?
I want to educate a young generation of endodontists to promote the quality of dentistry in my country. I would like to improve the understanding of dental trauma management worldwide.
Could you discuss some of the key principles or ideologies that guide your clinical practice?
The key principle of any success is persistence. I have found that persistence through many hardships will guarantee success. In my clinic, I demand from myself constant learning and persistence.
Who have been some of your chief mentors or influences throughout your career? How have they shaped your approach to Endodontics?
My chief mentor is Dr. Z Fuss, who taught me how to ask the right questions. My second mentor is Paul Dummer, who gave me the tools to write and publish articles.
In your opinion, what are the most exciting advancements or trends in Endodontics today?
The most interesting and helpful tool used to advance endodontics is the use of files, which improve tremendously the quality of endodontics.
Your research focuses on the influence of bacterial infection on disinfection methods in root canals and dentinal tubules. Can you share some current challenges in achieving optimal disinfection and how emerging medical treatments are improving success rates in root canal therapy?
My research focused on the ability of medicine to penetrate dentinal tubules and irregular spaces such as the isthmus. Medicines such as IKI, iodoform, CMCP, and in severe cases, antibiotics, were found to penetrate and disinfect the dentinal tubules from bacterial invasion. This is particularly important in cases of persistent apical periodontitis. Furthermore, teeth subjected to severe trauma, such as luxation or avulsion, can sustain significant injury to the protective cementum layer covering the root surface. When the cementum is damaged, bacteria from the dentinal tubules can invade the periodontal ligament (PDL), resulting in inflammation in the PDL surrounding the root, which presents a treatment challenge. A recently published article found that antibiotics promote healing in cases of apical lateral periodontitis.
Lin S, Moreinos D, Wisblech D, Rotstein I. Regenerative endodontic therapy for external inflammatory lateral resorption following traumatic dental injuries: Evidence assessment of best practices. Int Endod J. 2022; 55:1165-1176.
Lin S, Kfir A, Laviv A, Sela G, Fuss Z. The in vitro antibacterial effect of iodine-potassium iodide and calcium hydroxide in infected dentinal tubules at different time intervals. The Journal of Contemporary Dental Practice. 2009; 10(1):59-66.
Lin S, Levin L, Peled M, Weiss EI, Fuss Z. Reduction of viable bacteria, in vitro, in root canal tubules following treatment with clindamycin or tetracycline. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 2003; 96:751-756.
What advice would you give to aspiring Endodontists who are just starting their careers?
Insist that every single treatment is as good as you can give.
How do you balance your clinical practice with academic research and teaching responsibilities? What role do these activities play in your professional life?
It is extremely hard and demands sacrifice. You have to be ready and willing for it.
What motivates you the most in your daily work as an Endodontist? Could you share a memorable patient experience that reaffirmed your passion for this field?
The ability to help. It’s as simple as that: the satisfaction of seeing the relief in my patients is my motivation. I had a patient who was diagnosed with a dental issue, and I found out it was a neurological problem, which I identified and treated, preventing overtreatment.
Trauma management in dentistry is an evolving field. How has your research in dental traumatology informed new approaches to managing dental injuries, and what advancements do you foresee in this area for better patient outcomes?
The understanding of what medicine can disinfect bacteria in dentinal tubules is important in cases of inflammatory root resorption. The understanding is that follow-up is just as important as treatment and can prevent root resorption, which improves the long-term outcome.
Preventive approaches in oral surgery have the potential to reduce post-operative complications significantly. How has your work in preventive medicine influenced your surgical practices, and what preventive strategies do you find most clinically relevant?
The physiology of inflammation is not dependent solely on the presence or absence of bacterial infection. Over the last two decades, there has been an increasing understanding that injury or surgery to tissue can result in inflammation, which heightens discomfort and pain after surgery. A guideline has been introduced to reduce and even prevent swelling and pain. Administering NSAIDs such as Etodolac (Etopan) or steroids (Prednisone, Dexamethasone) one hour prior to surgery and once a day for three days afterwards helps to reduce pain and swelling compared to a placebo.
Lin S, Levin L, Emodi O, El-Naaj IA, Peled M. Etodolac vs. dexamethasone effect in reduction of post-operative symptoms following surgical endodontic treatment: a double-blind study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 2006; 101:814-817
I am happy to discover that the guideline that I suggested is now well-accepted around the world and is a basic treatment for inflammation and pain.
Top 3 journal recommendations in Endodontics?
International Endodontics Journal
Journal of Endodontics
Dental Traumatology
Top 3 book recommendations in Endodontics?
Pathways of the Pulp
Ingle
Endodontics Advances and Evidence-Based Clinical Guidelines
If you could deliver one message to Endodontists around the world, what would it be? How do you envision the future of Endodontics evolving?
Don't ever accept the facts as is. Always ask questions and rediscover the truth in every situation.
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