PULP FICTION
Volume 9 | September 2026
The Editor's Cut
Certainty, and what replaces it
Endodontics likes to sound certain. We give things names. We put numbers on displays. We tell patients everything went fine.
This edition is about the moments when certainty runs out and judgement has to take its place.
Winston Wolf opens with the moment every clinician recognises: the bur drops, there is more blood than you were expecting, and a small voice says “that’s not the canal”.
From the roof, Richard takes on two papers from the International Endodontic Journal, one that tells us what to call the anatomy we have been looking at for decades, and one that pools 40 studies without first asking whether the instrument can measure what it claims to.
Then two cases from the clinic that both come down to the same thing, treating exactly where the problem is and nowhere else.
Let’s clean this mess up properly.
Journal Dossier
Richard is back with two less-than-glowing reviews from the International Endodontic Journal.
A Glossary for Things We Already Know Are There
Ahmed et al. | A Consensus-Based Glossary for Controversial Terminology in Root and Canal Anatomy
Thirty-two experts, a Delphi process and 15 agreed definitions. Careful work, useful if you teach or study anatomy, and unlikely to improve anybody's access cavity. Richard still has no idea what a Transverse Canal Anastomosis is.
→ Read the Full Review
Garbage In, Garbage Out
Tietz et al. | Reference Values for Pulse Oximetry Testing in Permanent Teeth: A Systematic Review and Meta-Analysis
Forty studies pooled to produce a "normal" pulpal SpO₂. Richard, who designed a dental pulse oximetry probe himself and discussed the physics with the NIH scientist who modelled it, asks the question the review stepped around: can a pulse oximeter measure oxygen saturation in a tooth at all?
→ Read the Full Review
WINSTON WOLF
Houston, We Have a Perforation
You extend the access a little further. The bur drops. There’s bleeding. Quite a lot of bleeding.
A perforation doesn’t necessarily condemn the tooth, but what you do in the next five minutes can. Winston lays down his four-step STOP protocol, the things the wolf avoids at all costs, and the conversation nobody wants to have with a patient.
Case Studies
We’re thrilled to share some short case summaries from David.
The CPD Quiz
You’ve read it. Now prove it. Score 80% or more to earn one hour of verified CPD. Winston will be marking.
