Focus On: New Endodontic Technology

Carlos Alberto Spironelli Ramos, DDS, MS, PhD


Carlos Alberto Spironelli Ramos, DDS, MS, PhD, discusses professional and personal issues relevant to product development in his area of expertise. 

Q: How does one shift from being a clinical endodontist, endodontic professor, and researcher to a role as a product developer?

A: The day-by-day dental practice, especially in endodontics, is not composed of simple tasks. Necessity is the mother of innovation, and, when a dentist faces a challenging root canal treatment, he or she ends up creating inventive and personalized solutions. For several years, I was practicing endodontics while teaching, and, in both endeavors, I encountered several challenges for which I wasn’t always able to find solutions. In 2004, I was invited to lecture at an event called Roots in Salt Lake City. That is where I first met Dr. Dan Fischer and his Ultradent team. As a fellow dentist, Dr. Fischer had similar experiences in those blank spaces. The first product he invented was a hemostatic solution in response to the need for better control of bleeding during crown preparations and when taking master impressions. He showed me Ultradent’s philosophy of researching solutions and executing them properly—something that really clicked with me and matched my expectations of what a dental company should strive for.

Q: What is the development of a product like?

A: Creating new technologies—or improving the quality of existing ones, as most inventions are a series of improvements to an idea—is an ever-evolving process. Concepts are important to ignite the process, but the development of an idea, from the original design to the final product, is the real challenge. Development depends on highly skilled teams of professionals who don’t always appear to be the “stars” of a product, but are entirely essential. Without them, the idea for an innovative product may work in the inventor’s mind, but it might never become a reality in the marketplace.

Q: What is the biggest challenge for future technologies in endodontics?

A: For the majority of dentists, it seems that the greatest challenge is pain control. The most accessed papers in dental journals include endodontic research on pain management. I researched and wrote a 3-volume work on odontogenic pain to try to gain some more knowledge on the matter. Although we have advanced prominently in understanding how pain is transmitted from the pulp to the brain, we remain in the “ice age” with regard to diagnosis.

From a patient’s standpoint, root canal treatments remain a torment—a “painful” solution for a disease that shouldn’t exist anymore. The challenge is to reverse the ravages of dental caries; hence, we are witnessing the creation of treatment options that are more preventive in nature and include regenerative interventions.

Q: Competition between companies has increased as products with embedded technology are being manufactured at low cost and offered aggressively in the market. Do you see this as a threat?

A: Well, maybe for commoditized products, but not for high-end quality medical devices. Copycat companies (meaning those that only reproduce known products from other companies) do not have enough knowledge (or sometimes funding) to adequately test quality or add improvements; they depend on others to make progress. High-end technology companies can make a product that requires sophisticated manufacturing know-how, and copycats don’t even bother trying to reproduce it—they know they won’t succeed.

Q: How can a dentist choose between so many different options?

A: I believe that we must carefully follow all scientific advances, respecting the time necessary for research to show indispensable evidence-based results so we can make informed decisions. The time of innovation in medical science isn’t the same as in other areas of technology. I believe in thorough research and clinical experience, and both demand time.

Q: How can communication between dentists and developers improve?

A: One must fully comprehend the demands of dentistry and on making materials and techniques better for patients and doctors. Having a dentist in charge works like a bridge between developers and the customer. I have come to understand how important this bridge is, with the owner and staff in the company knowing exactly what the dental professional and the patient needs. Having customer service that genuinely cares, and allowing dentists to, for example, ask questions on social media, enables communication between the clinicians and developers to run effortlessly and efficiently.

Q: Based on your experience, what is the best way to make sure new products are being properly used by dentists?

A: With the advance and diversity of today’s technologies, there is a strong need for education and proper training. Nowadays, there are innovative methods, such as videos, online courses, virtual reality, etc. However, I still believe hands-on experience is essential. Why? Because at the end of the day, dentistry is not only a science; it’s an art.

Q: Is there anything else that you would like to share with our readers?

A: In closing, I would like to make a few personal remarks. I would never have gotten to where I am without 3 important behaviors: simplifying techniques for my fellow dentists, enthusiasm, and perseverance. Wanting to help others drove me to think outside the box and to invent ways to make things a little easier. Enthusiasm got me through the tough times because, with positive thinking, I made sure every day counted. In Brazil, I dreamed of moving to a country where the people will cherish someone’s values, so I did everything in my power to move here to the United States. And, most importantly, without perseverance, I would not have achieved anything. I came from a country where the people continue to experience numerous hardships. While I encountered countless setbacks and naysayers, I chose to overcome the hurdles and to keep on going, dreaming, and creating. I am thankful every day that I did and where it got me.

Dr. Ramos, a former endodontic professor in Brazil and currently endodontic manager at Ultradent Products, Inc, presents the challenges of developing new products, devices, and techniques for the improvement of the endodontic specialty. He can be reached via email at

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