IntroductionDevelopmental defects of enamel (DDE) encompass a spectrum of conditions that occur during tooth formation, including enamel fluorosis, molar–incisor hypomineralization (MIH), and other forms of enamel hypoplasia. It has been proposed that DDE are associated with nutritional deficiencies as well as environmental exposures during tooth development.ObjectiveThis scoping review summarized and analyzed the evidence on the association between dietary habits, environmental exposures, medical/health-related factors, demographic factors and biological factors and DDE aiming to provide a comprehensive overview of the available evidence in this area.MethodologyFollowing the Joanna Briggs Institute (JBI) framework using Population, Concept, and Context (PCC) to guide the development of the research question and eligibility. The population of interest were individuals from any age group or gender diagnosed with DDE. The eligibility concepts were factors that may contribute to DDE such as dietary and environmental exposures. The study selection followed the PRISMA guidelines. Studies published from January 1993 to December 2024 were identified through searches in Web of Science and PubMed.ResultsOur review included 125 studies from 1993 to 2024, mainly on fluorosis (105 studies), mostly cross-sectional, and conducted in Asia and North America. Fewer studies addressed MIH (5) and other non-fluorosis DDE (15), primarily in Europe, South America, and Asia, with most participants being children aged 6–12 years, and small sample sizes. The review evaluated DDE and its main subtypes, molar-incisor hypomineralization (MIH) and enamel fluorosis across conditions, overlapping risk factors were identified, such as excessive fluoride intake, vitamin D deficiency, early childhood illnesses, and exposure to environmental contaminants. Condition-specific patterns were also noted, fluorosis being primarily associated with high fluoride exposure and early weaning, whereas MIH was more frequently linked to vitamin D deficiency and early systemicConclusionThe findings highlight that enamel fluorosis, MIH, and other enamel hypoplasias are part of a shared continuum of DDE influenced by interrelated dietary, environmental, and biological factors. These findings suggest common developmental pathways leading to enamel disruption and emphasize the need for longitudinal and mechanistic studies to clarify causal relationships and inform preventive strategies.
Pradnya S. Jadhav, Siddhi Hathiwala, MR Arjun
et al.
Background:
Tobacco use remains a significant public health concern in both rural and urban populations, contributing to a wide array of oral and systemic health complications. Dental professionals play a pivotal role in identifying and educating patients about the risks of tobacco use and facilitating cessation. However, awareness levels and accessibility to cessation support may vary between rural and urban populations. This study aims to assess and compare the awareness of tobacco cessation among dental patients in rural and urban settings.
Materials and Methods:
A cross-sectional, questionnaire-based survey was conducted over a period of three months across two dental clinics—one located in an urban setting and the other in a rural area. A total of 400 patients were recruited (200 urban, 200 rural). A structured and validated questionnaire assessed awareness regarding the health risks of tobacco, knowledge of cessation methods, and attitude towards quitting. Data were analyzed using SPSS software Version 26.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and Chi-square tests were employed to determine significant differences between groups, with a significance level set at P < 0.05.
Results:
Out of the total 400 participants, 58% of urban patients demonstrated high awareness of tobacco-related health risks compared to 34% in the rural group. Knowledge of cessation aids like nicotine replacement therapy (NRT) and counseling was reported in 42% of urban respondents and only 18% of rural respondents. Willingness to quit tobacco use within the next six months was significantly higher among urban participants (64%) than rural participants (39%) (P = 0.002). The difference in awareness and readiness to quit between the two groups was statistically significant.
Conclusion:
The study reveals a considerable disparity in tobacco cessation awareness between urban and rural dental patients. Targeted educational and cessation interventions tailored to rural populations are essential to bridge this gap and promote healthier behaviors across all demographics.
Muhammad Mazher Irshad , Kausar Noor, Muhammad Imran Khan
et al.
Background: Laparoscopic surgery is increasingly preferred for various abdominal procedures due to its minimally invasive nature. However, port site complications, particularly wound infections, remain a significant concern. The method of umbilical access—either intra-umbilical or periumbilical—may influence the rate of postoperative infections, yet evidence comparing the two remains limited. The study aimed to compare the frequency of wound infection between intra-umbilical and periumbilical incisions in patients undergoing laparoscopic appendectomy or cholecystectomy.
Methods: A descriptive study was conducted over six months in the Department of Surgery at Khyber Teaching Hospital, Peshawar. A total of 201 patients undergoing laparoscopic surgeries were enrolled using a non-probability consecutive sampling technique. Patients were divided into Group A (intra-umbilical incision, n=101) and Group B (periumbilical incision, n=100). Baseline demographics, comorbidities, and type of surgery were recorded. Postoperative wound infections were assessed within two weeks based on predefined clinical criteria. Data were analyzed using SPSS v25, with Chi-square and Fisher's exact tests applied where appropriate.
Results: The overall wound infection rate was 11.4%, with 8 infections (7.9%) in Group A and 15 infections (15%) in Group B. The infection rate was nearly double in the periumbilical group compared to the intra-umbilical group. Other variables, including comorbidities and type of surgery, were comparable between the groups.
Conclusion: Intra-umbilical incisions were associated with a lower incidence of wound infections compared to periumbilical incisions in laparoscopic procedures. This method may offer a safer and cosmetically superior alternative for initial port access in routine laparoscopic surgeries
Roland Frankenberger, Andreas Koch, Lina Plohmann
et al.
(1) <b>Background:</b> The aim of this in vitro study was to evaluate the success of indirect pulp capping (IPC) procedures over a period of 40 years. (2) <b>Methods:</b> The investigation of 1412 dental records included 159 patients with 366 IPC teeth having been treated from 1969 to 1980. The teeth revealed caries within the inner third of dentin, were symptom-free, and showed no pulp exposure. The caries were excavated thoroughly and teeth with accidentally exposed pulp were excluded. Zinc–oxide–eugenol was used for the IPC procedures. The posterior teeth were restored with amalgam, and the anterior teeth received direct resin composite fillings. The gathered parameters with possible influences on survival rates were age, gender, tooth locations/positions, dates of vital therapy, the number of filled surfaces, types of primary restoration material, successional treatments on each tooth, and the last dates of surveillance. Data collection and statistical analysis were performed using Excel sheets and DataTab. Significant differences among groups were computed by cox regression analysis and the significance level was set at <i>p</i> = 0.05. Kaplan–Meier curves were utilized to illustrate the survival rates. (3) <b>Results:</b> Treatment success was measured by the maintenance of vitality beyond 365 days. The loss of vitality within 365 days was determined as treatment failure. Treatment outcomes were assessed after different time periods (1 and 6 months; 1, 2, 5, 10, 20, and 40 years). Pulp vitality dropped from 95% after 3 months to 32% after 40 years. Cavity size had a significant influence on the survival of pulp, but tooth position did not; however, third molars at least initially showed a better outcome. Beyond the 1-year recall, no differences for the evaluated parameters were present. (4) <b>Conclusions:</b> IPC showed excellent long-term success rates, revealing a 1.7% annual failure rate after 40 years of clinical service. Larger defects suffer more pulp damage in the long run.
Objectives This study aimed to assess the publication rates of abstracts presented at the ConsEuro Congress using a web-scraping method and to analyze factors correlated with these publication rates. Methods Abstracts presented at eight ConsEuro meetings held between 2003 and 2019 were evaluated for subspecialty, study design, number of authors, and the country of the principal investigator’s institution. For abstracts confirmed as subsequently published using a web-scraping method, the following data were recorded: time to publication, the journal of publication, impact factor, quartile, index status, Scientific Journal Ranking of the journal at the year of publication, and changes in the number of authors after publication. Results Out of 1,426 abstracts presented, 478 were published in peer-reviewed journals, yielding a publication rate of 33.5%. The median time to publication was 12 months. The leading journal in terms of publication rate was Clinical Oral Investigations. There was no statistically significant difference in publication rates across years. Abstracts related to laser therapy, caries, and dental materials had significantly higher publication rates compared to other subspecialties. Animal, basic, and clinical research studies were more likely to be published. Both study design and subspecialty influenced publication rates, which decreased over time. Conclusions A considerable amount of scientific data and preliminary results presented at conferences, which could contribute to scientific knowledge, are overlooked due to low publication rates. The findings of this study may encourage ConsEuro participants to submit well-planned and rigorous studies that are more likely to complete the full publication process.
Abstract Aim The study aimed to compare the effects of endodontic microsurgery, fiber post, horizontal bone loss, and their combinations on the biomechanical behavior of a maxillary central incisor using finite element analysis (FEA). Material and methods A maxillary central incisor was modeled along with different variations: one with endodontic treatment (coded E), endodontic microsurgery with 3 mm and 5 mm root-resection (coded R3 and R5), restoration with a fiber post (coded P), 3 mm horizontal bone loss (coded B), and combinations of these parameters. The models were subjected to a 250N load, and von Mises stress distribution was analyzed. Results Models R3 and R5 showed stress distribution in the coronal third, similar to P.R3 and P.R5. The E.P and P.B models exhibited stress in the coronal and middle thirds. Models with combined parameters (R3.B, R5.B, P.R3.B, P.R5.B) experienced stress throughout the root. The crown-root ratio (CRR) changes did not significantly affect stress values but altered stress distribution. Root-end resection, fiber post, and their combinations did not significantly increase stress. No notable difference was found between 3 and 5 mm resections. Horizontal bone loss, with or without a post, significantly increased stress. The combination of all three parameters resulted in stress throughout the root, but no additive effect on von Mises values was observed. Conclusions The presence of bone loss and the decisions to have endodontic microsurgery, and/or post-core restorations are factors that affect the biomechanical behavior of teeth independently or combined. These variables interact and affect stress distribution patterns and values, especially within the investing bone.
Ming-Sung Hsu, Tung-Lin Tsai, Shih-Jung Cheng
et al.
Background/purpose: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that is often treated by mandibular advancement devices (MADs). However, conventional MADs are frequently associated with discomfort, rigidity, and limited patient compliance. This study aimed to design and evaluate a custom-made anti-snoring device featuring a nickel-titanium (Ni–Ti) alloy elastic connector to improve comfort, durability, and clinical performance. Materials and methods: The device consisted of dual-layer upper and lower trays and was connected via Ni–Ti alloy rods. Finite element analysis (FEA) was conducted to compare the stress and deformation characteristics of three materials (Ni–Ti, stainless steel, and polycarbonate). Fatigue testing was also performed to simulate the long-term use. A clinical simulation involving seven adult participants diagnosed with mild to moderate OSA was conducted, including a seven-day trial and a post-trial questionnaire that evaluated comfort, fit, and effectiveness. Results: FEA revealed that the Ni–Ti connector exhibited the most uniform stress distribution and the highest deformation capacity, indicating superior elasticity and resilience. Fatigue tests confirmed the structural stability after 5 million cycles. Subjective evaluations indicated the high user satisfaction and effective symptom relief; however, some discomfort related to oral dryness and temporomandibular joint (TMJ) pressure was reported. Conclusion: The Ni–Ti-based anti-snoring device demonstrated favorable biomechanical properties and clinical usability. It offers a promising alternative to traditional MADs, potentially enhancing a long-term patient compliance and therapeutic outcomes. Further clinical validation is warranted.
Qonita Rachmah, Prasenjit Mondal, Hai Phung
et al.
Abstract
Objective:
Numerous studies have examined the relationship between overweight/obesity and iron deficiency anaemia (IDA) across diverse population groups, but a definitive link has not been clearly determined. This systematic review examined the association between overweight/obesity and IDA in women of reproductive age (WRA).
Design:
The initial search was performed in the CINAHL, Embase, MEDLINE, SCOPUS and Web of Science databases. The studies included should report at least one Fe status with/without an inflammatory marker, using the BMI to define overweight/obesity. Only baseline data were extracted for longitudinal studies.
Setting:
Global.
Participant:
Pregnant or non-pregnant women aged 18–50 years.
Results:
In total, twenty-seven papers were included (twelve addressing pregnant women and fifteen addressing non-pregnant women). Overall, most of the studies reported no association between overweight/obesity and Hb concentration. However, a positive association was reported more frequently in pregnant women. The association between overweight/obesity and serum ferritin concentrations was mixed. Most of the studies on non-pregnant women reported a positive association. Only a few studies measured hepcidin and inflammatory markers, and the majority revealed an increased level among overweight/obese WRA. Among pregnant women, overweight/obesity was positively associated with anaemia and IDA but negatively associated with iron deficiency (ID). Meanwhile, overweight/obese non-pregnant women were positively associated with anaemia, ID and IDA.
Conclusions:
Overweight/obesity was associated with a decreased prevalence of anaemia and IDA but an increased prevalence of ID, while its association with several Fe markers was inconclusive. Further studies integrating the assessment of various Fe markers, inflammatory markers and hepcidin are needed.
Public aspects of medicine, Nutritional diseases. Deficiency diseases
Djalma Maciel de Lima, Cyntia Rodrigues de Araújo Estrela, Cristiane Martins Rodrigues Bernardes
et al.
(1) Background: This study assessed the spatial position and anatomical features associated with impacted third molars through a map-reading strategy employing cone-beam computed tomography (CBCT). (2) Methods: The positioning of impacted third molars on CBCT was assessed using Winter’s and Pell and Gregory’s classifications. External root resorption in mandibular second molars was categorized according to Herman’s classification. Additionally, the relationship between the mandibular third molar root apex and the mandibular canal was examined. Comparative statistical analysis was conducted using Fisher’s exact test, with a significance level considered as 5%. (3) Results: The results indicated that, based on Winter’s classification, 48.06 % of impacted teeth were positioned mesioangularly. Employing Pell and Gregory’s classification, 43.22% of the impacted molars fell into positions B and C, with 54.2% classified as Class II. A notable 69.7% of teeth exhibited no contact between the root apex and the mandibular canal, and external root resorption in the distal aspect of the second molar was absent in 88.7% of cases. (4) Conclusions: Utilizing the map-reading strategy with CBCT scans to assess the anatomical positions and characteristics of impacted third molars enhances professional confidence and sets a standard for quality and safety in the surgical procedure for patients.
Guglielmo Campus, John Yun Niu, Berkant Sezer
et al.
Abstract The 2017 Global Disease Study revealed 2.3 billion untreated cavities and 139 million other oral conditions like dental erosion. Modern treatments prioritise controlling etiological factors and preventing related diseases. This Editorial invites researchers to contribute to the collection, ‘Prevention and management of dental erosion and decay’.
Olufemi Erinoso, Afolabi Oyapero, Oluwabukunmi Familoye
et al.
Introduction
Health insurance is a health-financing
mechanism to protect people from catastrophic healthcare
costs and limits out-of-pocket spending on healthcare, which
is directly linked to poverty. This study assesses the extent
of health-insurance uptake and associated factors in Lagos,
Nigeria.
Methods
We conducted a cross-sectional survey of
consenting adults residing in Lagos, Nigeria. Participants
were enrolled at general outpatient clinics of four
public health facilities in Lagos State. Sociodemographic
characteristics and data on health-insurance uptake were
obtained and grouped into uninsured, National Health-
Insurance Scheme (NHIS) and Private Health-Insurance
(PHI). Factors associated with health-insurance uptake was
determined using chi-squared tests and logistic regression
models. Statistical significance was placed at p<0.05.
Results
A total of 1000 respondents were enrolled in the
study. Overall, 9.5% of participants had health-insurance:
NHIS (5.6%) and PHI (3.9%). Males had a higher healthinsurance
uptake than females (p=0.035). Respondents who
were married had higher odds of health-insurance uptake
than those that were single (AOR=2.23; 95% CI: 1.20–4.16;
p=0.01). Similarly, respondents who had a secondary-school
diploma had higher odds of having a health insurance
compared to those with less than a secondary-school
education (AOR=5.20; 95% CI: 1.14–23.68; p=0.03).
Conclusions
Our findings suggest a low rate of healthinsurance
uptake in the population. Being male, married
and possessing a secondary school diploma or higher were
associated with higher odds of health insurance uptake.
Policy measures should focus on expanding access to health
insurance, particularly among the less educated and the
informal employment sector.
Dimitra Galiti, Helena Linardou, Sofia Agelaki
et al.
Introduction: The increasing burden of cancer, the development of novel therapies, and the COVID-19 pandemic have made cancer care more complex. Digital innovation was then pushed toward developing platforms to facilitate access to cancer care. Age, education, and other disparities were, however, shown to limit the use of the digital health innovation. The aim of this early-stage feasibility study was to assess whether Greek cancer patients would register at CureCancer and self-report their demographics, disease and therapy characteristics, and socioeconomic issues. The study was organized by the Hellenic Society of Medical Oncology. Methods: Patients from nine cancer centers were invited to register on the CureCancer platform and complete an anonymous questionnaire on demographics, disease and therapy characteristics, and socioeconomic issues. Patients were also encouraged to upload, in a secure area for them, their medical files and share them with their physicians. They were then asked to comment on their experience of registration and how easy it was to upload their medical files. Results: Of the 159 patients enrolled, 144 (90.56%) registered, and 114 of those (79.16%) completed the questionnaire, suggesting that the study is feasible. Users’ median age was 54.5 years, and 86.8% of them were university and high school graduates. Most patients (79.8%) reported their specific type of cancer diagnosis, and all reported their therapy characteristics. Breast and lung cancers were the most common. A total of 87 patients (76.3%) reported being on active cancer therapy, 46 (40.4%) had metastatic disease, and 51 (44.7%) received supportive care medications. Eighty-one (71.05%) patients received prior cancer therapies, and twenty-seven recalled prior supportive care medications. All patients reported visiting non-oncology Health Care Professionals during the study. Nineteen of 72 (26.39%) patients who worked prior to cancer diagnosis changed work status; 49 (42.98) patients had children under 24 years; and 16 (14%) patients lived alone. Nine (7.9%) patients were members of patient associations. Registration was “much/very much” easy for 98 (86.0%) patients, while 67 (58.8%) had difficulties uploading their files. Patients commented on the well-organized data access, improved communication, feeling safe, medication adherence, interventions from a distance, and saving time and money. Over 80% of patients “preferred the digital way”. Discussion: A total of 114 patients succeeded in registering on the digital platform and reporting their demographics, disease and therapy characteristics, and socioeconomic issues. Age and educational disparities were disclosed and highlighted the need for educational programs to help older people and people of lower education use digital innovation. Health care policy measures would support patients’ financial burden associated with work changes, living alone, and children under 24 years old at school or college. Policy actions would motivate patients to increase their participation in patient associations. According to the evidence DEFINED framework, the number of patients, and the focus on enrollment, engagement, and user experience, the study fulfills actionability level criterion 1.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Monika Srivastav, Thayalan Dinesh Kumar, Elizabeth C Dony
Background: The common belief amongst the consumers of smokeless tobacco products is Smokeless Tobacco Products (STPs) are not hazardous as smoking tobacco. Any form of tobacco consumed is addictive and the nicotine absorbed from these products is manifold higher than the nicotine produced and delivered from a cigarette. Aim: The aim of this narrative review is to consolidate and summarize the data from various studies to find out whether smokeless tobacco products are less harmful than smoking tobacco products or vice-versa. Method: A comprehensive literature search was conducted using various databases like EBSCO, Google scholar, Pubmed, Embase from 1957 to 2021. The keywords used for search was 'smokeless tobacco products', 'bacterial population AND smokeless tobacco products', 'water content, pH in STP'. Result: In total, 52 articles were selected to analyze the parameters, which proved increasing carcinogenicity in smokeless tobacco products. Various parameters were analyzed which include pH, water content, manufacturing procedure of STP and microbial population in smokeless tobacco products. Conclusion: The literature search suggests that the microbial population in smokeless tobacco products acts as a cascading series of events in carcinogenesis and other opportunistic infections and concludes that smokeless tobacco products are equally harmful as smoking tobacco products.
Dr Yasir Naqi Khan, Dr Muhammad Ashfaq, Dr Bader-u-Nisa
et al.
Objective: Diabetes mellitus (DM) is a complicated, prolonged metabolic disorder that leads to hyperglycemia and it occurrs due to complete deficiency of insulin with or with insulin resistance. The most common type of DM in children and adolescents is Type-1 DM (T1DM). The aim of this study was to determine the associations of IAA, GAD65 and IA-2A antibodies in type 1 diabetes mellitus with age, gender and duration of disease.
Methodology: This was a retrospective study conducted in the NICH hospital at the department of endocrinology and diabetes by using non probability consecutive sampling technique, after taking ethical approval. The duration of the study was one year. A total of 143 patients with clinically diagnosed type 1 diabetes ( ?1 year to ?20 years of age, regardless of the duration of the disease) were selected for the study. All study subjects were investigated for pancreatic autoimmune markers (GAD65, IA-2A, IAAs). Pearson’s Chi square test was applied to evaluate the association.
Results: A total of 143 children diagnosed with type 1 diabetes were enrolled for this study wherein 71(49.7%) were males and 72(50.3%) were females. Regarding the distribution of positivity of autoantibodies, 27(18.9%) had AntiInsulin IgG, 63(44.1%) had GAD65, 47(32.9%) had IA-2A and only 5(3.5%) had grey zone. There was a significant association was reported (p<0.001) in duration of diabetes and with IAA. Furthermore, there was a statistically significant association with (p=0.003) duration of diabetes and frequency of IA-2A.
Conclusion: This study concluded that presence of autoantibodies such as insulinoma-associated antigen-2 autoantibodies, Insulin autoantibodies and glutamic acid decarboxylase 65 were found to be predominant in males than females although it was not significantly associated with age and gender. Additionally, presence of insulinoma-associated antigen-2 autoantibodies, Insulin autoantibodies significantly associated with the duration of disease.
Abstract Background Sliding mechanics with miniscrews is recently used for extraction space closure. The purpose of this study was to elucidate how and why the archwire size affects long-term tooth movement in miniscrew sliding mechanics. Methods Long-term orthodontic tooth movements were simulated based on a remodeling law of the alveolar bone by using a finite element method, in which the bracket rotated freely within a clearance gap (a play) of the archwire-bracket slot. The archwire size was changed to 0.021, 0.018, and 0.016 in. for the 0.022-in. bracket. Result Lingual crown tipping and extrusion of the incisors increased with decreasing the archwire size. Movements of the posterior teeth were approximately the same irrespective of archwire size. Conclusions When decreasing the archwire size, a play of the archwire-bracket slot, as well as the elastic deformation of the archwire, resulted in lingual tipping of the incisors. This tipping led to extrusion of the incisors.
Introduction: Green tea is a beverage which is consumed worldwide and is reported to have anti-cariogenic effect. So, if it was as effective as chlorhexidine (CHX) mouth rinse against cariogenic microbes it could be considered a natural, economical alternative. The purpose of this study was to evaluate and compare the anti-microbial efficacy of 0.5% green tea and 0.2% CHX mouth rinses against Streptococcus Mutans, Lactobacilli spp. and Candida Albicans. Materials and Methods: 30 children aged 4-6 years with S-ECC (based ondefs score) were selected. Children were divided randomly into 2 equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and post rinsing non-stimulated whole salivary sample (2 ml) was collected and tested for the number of colony forming units. The data was statistically analyzed using SPSS v16.0 software with one-way ANOVA and Tukey′sPOSTHOC test. Results: A statistically significant fall in colony count was found with both the mouth rinses in Streptococcus Mutans (P < 0.001, P < 0.001) and lactobacilli (P < 0.001, P < 0.001) but not against Candida albicans (P = 0.264, P = 0.264). Against Streptococcus Mutans, green tea mouth rinse was found to be significantly better than CHX mouth rinse (P = 0.005). Against lactobacilli spp, CHX mouth rinse was significantly better than green tea mouth rinse (P < 0.001). Conclusion: Green tea mouth rinse can be considered safe, economical and used without much concern. However, further studies are recommended.
INTRODUCCIÓN: restaurar dientes tratados endodónticamente implica tratar la dentina con sustancias desinfectantes y ácidas que mejoran la adhesión, pero generan cambios estructurales e irreversibles en la misma. El objetivo de este artículo fue detallar y analizar los cambios en la estructura y las propiedades mecánicas, descritas en la literatura, que producen el hipoclorito de sodio al 5,25%, ácido etilendiaminotetraacético, (EDTA), al 17% y la clorhexidina al 2% sobre la dentina tratada endodónticamente. MÉTODOS: se buscó en las bases de datos: Scient Direct, Pubmed, Scielo y EbscoHost las palabras clave "Human Dentin"and "Root Canal" and "Human Dentin and Change, "Dentin Treated" y "Treated dentin and Chlorhexidine", seleccionando 67 artículos que cumplieron con describir y detallar los cambios en la dentina cuando es irrigada con hipoclorito de sodio al 5,25% y ácido etilendiaminotetraacético,(edta), al 17% y clorhexidina al 2% en diferentes momentos del tratamiento. RESULTADOS Y CONCLUSIONES: se encontró que la dentina tratada presenta cambios, como pérdida de la arquitectura dentinal, el contenido iónico y la matriz orgánica, reducción en la microdureza, la nanodureza, y la resistencia tensil, y compresiva. La dentina tratada endodónticamente, es un sustrato alterado químicamente que repercute en sus propiedades y en la durabilidad de la adhesión.