00:00Could it be that root canal treatment, as dentists have practiced it for decades, has its days numbered?
00:07Today, this is one of the treatments practiced to avoid tooth extraction.
00:11Today, CIMS is seeking to open a door that has been closed until now.
00:15And opening that door would lead to the regeneration of the dental pulp.
00:19I call the pulp what many patients call the nerve of the tooth.
00:23Today we're going to analyze, based on scientific evidence, how close dentistry is to becoming dentistry.
00:27to bring back to life a tooth that has lost its dental pulp,
00:30instead of emptying the pipes or sealing them with inert material.
00:34Think about it for a moment.
00:36The gutta-percha we use today is basically a polymer, a type of plastic.
00:41It does its job of sealing the canals, yes, but it leaves the tooth like a block of cement.
00:47without blood supply and without the ability to defend oneself.
00:50We are filling life with plastic.
00:53If you are an adult, chances are you've had it done at some point in your life
00:56some root canal treatment on one of your molars.
00:59And yes, it has the advantage of reducing the number of teeth extracted, but at a cost to you.
01:05This is because by emptying the teeth of the pulp that is in their canal and pulp chamber,
01:10The tooth stops receiving nutrients, loses its ability to feel,
01:14and over time it can even become somewhat fragile.
01:17However, this is where the history of dentistry could take an unexpected turn.
01:22thanks to scientific research.
01:23I've been analyzing a high-level systematic research study
01:27which seeks to change the perspective on how to perform root canal treatments.
01:32This is a systematic investigation published at the end of 2024
01:36which doesn't mean that root canals are going to disappear tomorrow,
01:41But it does show that in dentistry we have the technology to create a different alternative,
01:48an alternative treatment.
01:49And I'm talking about tissue engineering so that your own stem cells
01:53Rebuild the inside of your tooth, what's inside the root canals of your molars.
01:59If a tooth decay perforates your tooth, it indicates a cavity and bacteria have reached the pulp.
02:04and have caused an irreversible process,
02:07that so far the dentist's response has been to empty the canals,
02:11wash, shape and seal them.
02:14But researchers are seeking to create a new treatment based on living biology.
02:18I am dentist Luis Marcano and one of my goals is to help you separate
02:22What we do today in dental consultations compared to what could be done in the future
02:27thanks to scientific research.
02:29And what we could do in the future is what they are trying to create at the University of Bari, Italy.
02:35and at the University of Birmingham, in the United Kingdom.
02:38Since researchers are looking to prevent dentists from removing the pulp from your tooth
02:43Instead, let's look for and apply treatment to heal that pulp.
02:48Or if the tooth has already been lost, they can regenerate, induce the regeneration of that internal tissue of your tooth.
02:55But what is this possibility based on?
02:57This systematic research focuses on the use of stem cells from dental pulp,
03:02cells that live inside your tooth and have an amazing ability to repair themselves.
03:07Let's say they are rescue communities that respond when called upon.
03:10They have found that by combining stem cell production with certain chemical stimuli
03:14and with a vehicle, they can get these to activate regeneration,
03:19the generation of new blood vessels and nerve tissue within the tooth.
03:23This would help your tooth regain its ability to be nourished by the human body.
03:27and besides, it regains its sensitivity.
03:30This would completely change what we interpret today when we hear the expression
03:33root canal treatment.
03:36But, and this is a big but, science still encounters an obstacle at this point.
03:39And this obstacle comes in the form of a question,
03:42How can we make those stem cells specifically produce healthy and functional dental pulp?
03:50and not another one?
03:51Because if these stem cells cannot be guided precisely,
03:55local dental regeneration would fail.
03:58To help you visualize this, imagine you walk into a library
04:01and you find 851 folders that tell you about dental pulp regeneration.
04:08851.
04:09I ask you, do you think that just by being there all those folders and all that information are reliable?
04:14My answer is no.
04:16That is why the authors of the systematic research I am citing
04:19They set to work filtering all that information.
04:23To separate the more solid scientific data from what were just opinions or video reviews.
04:29Imagine this phase of this systematic investigation as a scanner,
04:32as a quality filter through which the other investigations they were reviewing would pass.
04:37This is to rule out investigations that had what we'll call doctored data.
04:42Or in other words, with a level of bias, with a level of tendency.
04:45They also discarded investigations where key information was missing.
04:49They wanted to find only the best in a period of 10 years of research.
04:54And this is to discover how possible it is to bring back a toothache.
04:58And what happened was that out of 851 investigations, they kept 15 that they considered the most reliable.
05:05And this is to answer the question, how can a tooth recover its pulp, regain its vitality?
05:12Let's then turn to what these investigations reveal.
05:15Think about it: stem cells need a physical signal.
05:18This is because stem cells respond differently depending on the material they are in contact with.
05:24For example, if they are in contact with a rigid material, they tend to form bone.
05:28But if the stem cell is in contact with a soft, elastic material,
05:32The signal is activated to form soft tissue.
05:34For example, dental pulp.
05:36Putting the stem cells in contact with a soft material, with a vehicle in the conduits,
05:41This is how researchers would try to create dental pulp again inside the canals of your tooth.
05:47It's like planting a seed.
05:49If you put it on asphalt, it won't grow.
05:51If you plant it in fertile soil, it will bloom.
05:54Here, the elasticity of the hydrogel is that fertile ground that tells the cell,
05:59Don't worry, it could be soft, living tissue here.
06:02You don't need to turn into bone to protect yourself.
06:05And the story doesn't end there, because in addition to the physical signal,
06:08Stem cells also need a chemical signal.
06:11And at this stage of the study, the researchers highlighted a natural compound that has been extensively researched in China.
06:15In practice, this prolongs the life of the cell and accelerates its division.
06:20It is a way to promote growth from the moment the cell is removed.
06:23And this again to rebuild the internal system of the tooth, the pulp.
06:27But you might be wondering, how do all these parts of the playful investigation work?
06:32How does pulp regeneration become a reality?
06:34As you will soon realize, all these variables need to work together.
06:38The physical signal, the chemical signal.
06:40And this is also in conjunction with the use of a drug called Tideglucid,
06:45which would help stem cells multiply.
06:47As a dentist, what gives me peace of mind about this research is that we are not experimenting blindly.
06:55This drug, Tideglucid, has already undergone clinical trials for other pathologies.
07:00In other words, we already know its safety profile in humans, which greatly shortens the path for you and
07:07I'll see it applied in the consulting room chair.
07:10But in that multiplication of stem cells they would need to be in an elastic filling material.
07:15And as I told you recently, being in contact with a soft material,
07:19The stem cell understands, in quotes, that it must form soft tissue, form dental pulp.
07:24In conjunction with the plant compound, which would help to maintain cell activation for a period of time
07:30enough
07:30to achieve the goal of regenerating the dental pulp or healing it if it is already compromised.
07:35And we would move away from treatments that empty the canals and seal them with a polymer,
07:40to treatments that regenerate dental pulp in those canals.
07:43What I'm telling you is that there is no single solution from a single source, from a single investigation.
07:49But from my professional perspective and from reading this research,
07:53What the authors suggest is the integration of different methods to achieve the regeneration of your pulp
07:58tooth.
07:59And by the way, not only the pulp, but also the perenotal ligament and even the alveolar bone.
08:03In fact, the authors themselves highlight the importance of their integration of methods
08:07and the need for future research to make this a reality.
08:11And once that goal is achieved, we could see a radical change in the way root canals are treated.
08:18Until the next video.
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