{"id":13945,"date":"2025-10-27T17:08:06","date_gmt":"2025-10-27T15:08:06","guid":{"rendered":"https:\/\/innovationmedical.ro\/?p=13945"},"modified":"2026-03-31T00:42:45","modified_gmt":"2026-03-30T21:42:45","slug":"modern-endodontics-isolation-magnification-and-laser","status":"publish","type":"post","link":"https:\/\/innovationmedical.ro\/en\/endodontia-moderna-izolare-magnificare-si-laser\/","title":{"rendered":"Modern Endodontics 2026 \u2013 Isolation, Magnification, and Laser"},"content":{"rendered":"
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1. Insulation<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Modern endodontics is performed with isolation, lasers, and magnification. If we do not use isolation, we cannot speak of actual endodontics, as the inside of the tooth is contaminated with blood and saliva from the oral cavity, which harbors the most complex bacterial flora in the human body.<\/span><\/span><\/span><\/p>

Isolation is achieved with a rubber dam \u2013 a thin latex sheet secured to the treated tooth with a clamp, to completely separate it from the rest of the oral cavity. Thus, we work in optimal conditions of sterility and control, in a regimen similar to surgery.<\/span><\/span><\/span><\/p>

Innovation Medical Center offers laser endodontic treatments, with technology at the 2026 level, making it a leader in Romania in laser dentistry. Innovation Medical Center is an associated center and European partner of Sigmund Freud University Vienna and AALZ Germany, being affiliated with ISLD, which guarantees clinical practices aligned with international academic and scientific standards in laser dentistry and TMJ therapy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Magnification<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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The second essential element is <\/span><\/span><\/span>microscope<\/b><\/span><\/span><\/span>.We are working in the smallest cavity in the human body, and for correct treatment, it is essential to clearly see the internal structures. Endodontic anatomy is complex, with numerous morphological variations and collateral canals.<\/span><\/span><\/span><\/p>

If these channels are not visible, they cannot be treated, which frequently leads to failures.<\/span><\/span><\/span><\/p>

Example:<\/b><\/span><\/span><\/span> A premolar two upper - usually with a single canal - was treated twice unsuccessfully. Under the microscope, it was identified <\/span><\/span><\/span>Three channels<\/b><\/span><\/span><\/span>, explaining recurrence. The postoperative X-ray shows complete three-dimensional obturation of all canals and the presence of white dots in the apical third of the root, corresponding to collateral canals that were correctly treated and obturated.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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3. The laser<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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The third element \u2013 and probably the biggest revolution in endodontics<\/a> modern - it is <\/span><\/span><\/span>the laser<\/b><\/span><\/span><\/span>.In endodontics, two wavelengths are primarily used: <\/span><\/span><\/span>Erbium<\/b><\/span><\/span><\/span> and <\/span><\/span><\/span>diode laser<\/b><\/span><\/span><\/span>.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Erbium laser<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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The Erbium laser has a wavelength that is simultaneously absorbed in <\/span><\/span><\/span>hydroxyapatite<\/b><\/span><\/span><\/span> and <\/span><\/span><\/span>water<\/b><\/span><\/span><\/span>.It emits extremely short and intense pulses, which generate the phenomenon of <\/span><\/span><\/span>cavitation<\/b><\/span><\/span><\/span>, producing negative pressure inside the tooth.<\/span><\/span><\/span><\/p>

This pressure helps to <\/span><\/span><\/span>draining of main and collateral channels<\/b><\/span><\/span><\/span> more efficient than any classical method. At the moment of impact, a <\/span><\/span><\/span>shock wave<\/b><\/span><\/span><\/span>, which breaks down the bacterial biofilm and causes the collapse of infected cells.<\/span><\/span><\/span><\/p>

Biofilm is one of the biggest challenges in endodontics, being a layered matrix of bacteria resistant to chemical agents. In conventional endodontics, <\/span><\/span><\/span>sodium hypochlorite<\/b><\/span><\/span><\/span> It eliminates only the bacteria it comes into contact with. By using the Erbium laser, the biofilm is completely dislodged and eliminated, facilitating the destruction of bacteria from within.<\/span><\/span><\/span><\/p>

At the same time, absorption into the water molecule leads to <\/span><\/span><\/span>Explosive evaporation<\/b><\/span><\/span><\/span> of this, releasing <\/span><\/span><\/span>OH radicals<\/b><\/span><\/span><\/span>, with a strong bactericidal effect.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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b. Diode laser<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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After using Erbium, it is used <\/span><\/span><\/span>diode laser<\/b><\/span><\/span><\/span>, whose wavelength is absorbed in <\/span><\/span><\/span>melanin<\/b><\/span><\/span><\/span> pigment present in the cell membranes of many bacteria.<\/span><\/span><\/span><\/p>

Through irradiation, intracellular temperature rises rapidly, causing <\/span><\/span><\/span>Bacterial lysis and destruction<\/b><\/span><\/span><\/span>.The result is a <\/span><\/span><\/span>Superior disinfection<\/b><\/span><\/span><\/span> compared to conventional methods.<\/span><\/span><\/span><\/p>

An additional advantage of the laser is <\/span><\/span><\/span>selectivity<\/b><\/span><\/span><\/span>energy is absorbed specifically by melanin, but it can <\/span><\/span><\/span>penetrates dentin up to 1 cm<\/b><\/span><\/span><\/span>, allowing the destruction of bacteria in mechanically inaccessible areas \u2013 including in <\/span><\/span><\/span>Dentin tubules<\/b><\/span><\/span><\/span>.<\/span><\/span><\/span><\/p>

Dentin tubules, microscopic components of dentin structure, can harbor deeply infiltrated bacteria. In classic endodontics, sodium hypochlorite penetration is limited to approximately 0.3 mm, while deep infections can exceed 1 mm.<\/span><\/span><\/span><\/p>

Diode lasers, by absorbing melanin, can <\/span><\/span><\/span>Destroys bacteria effectively up to 1 mm deep<\/b><\/span><\/span><\/span>, significantly increasing the chances of therapeutic success.<\/span><\/span><\/span><\/p>

A particularly resistant bacterium is <\/span><\/span><\/span>Enterococcus faecalis<\/i><\/span><\/span><\/span>, difficult to eliminate with hypochlorite. Although it has low melanin content, the combined effect of <\/span><\/span><\/span>Thermal shock and pressure wave<\/b><\/span><\/span><\/span> Erbium allows its destruction.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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4. Clinical cases<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Case 1 - Upper premolar with three canals<\/b><\/span><\/span><\/span><\/p>

The upper second premolar, which had previously been treated twice without isolation, a microscope, or a laser, relapsed. Thanks to microscopic examination, three root canals were discovered, a rarity (incidence 0.5\u201311%).\u2028The postoperative radiograph shows complete three-dimensional obturation, including the lateral canals, performed using an Erbium laser, which ensured thorough cleaning of the endodontic system.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Case 2 \u2013 Lower molar with six canals<\/b><\/span><\/span><\/span><\/p>

A lower first molar that appeared radiographically standard was found, under the microscope, to have six canals, an extremely rare case. Without magnification, these canals could not have been detected, which would have very likely led to recurrence.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"six-channel\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Case 3 - Mandibular molar with perforation and over-instrumentation<\/b><\/span><\/span><\/span><\/p>

The case presented a perforation and an overextended gutta-percha cone, which would normally have required surgery. Due to proper isolation with Nic Tone rubber dam and the use of two lasers, disinfection was superior, the area did not become infected, and the overextended cone appeared perfectly integrated on the radiograph taken 18 months postoperatively.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Case 4 \u2013 Upper molar with roots in the maxillary sinus<\/b><\/span><\/span><\/span><\/p>

\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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A maxillary molar with roots in the maxillary sinus was accidentally perforated by another doctor during the initial procedure (without a microscope), creating a direct communication with the sinus. In conventional endodontics, this case would have been considered untreatable, as working with sodium hypochlorite in the sinus is impossible. The classic alternative would have been extraction, sinus lift, and implant \u2013 a complex and lengthy procedure.<\/span><\/span><\/span><\/p>

In our clinic, the laser has allowed <\/span><\/span><\/span>saving the tooth<\/b><\/span><\/span><\/span>, as only water and light were used, without irritants for the sinuses. The perforation was closed with a biocompatible and bactericidal cement, and the tooth was restored prosthetically. At <\/span><\/span><\/span>The 9-month control CT scan<\/b><\/span><\/span><\/span>, the maxillary sinus appears completely clear and healed.<\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Frequently Asked Questions About Modern Endodontic Treatments<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\tWhy is rubber dam isolation necessary?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

To avoid contamination of the tooth with saliva or blood and to work in a completely sterile environment.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t2. Does the laser treatment hurt?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

\u2028No. The laser is gentle, precise, and significantly reduces postoperative inflammation and pain.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t3. Why is a microscope used in endodontics?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Because it allows us to see hidden or very fine channels that would otherwise be impossible to treat.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t4. What does the laser do during treatment?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Deeply cleans and disinfects canals, eliminating bacteria and biofilm.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t5. Is the laser dangerous for teeth?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

It acts selectively only on bacteria and infected tissues, without affecting healthy structures.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t6. Can a tooth considered lost be saved through laser endodontic treatment?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Yes, in many cases, the laser allows us to save teeth that previously would have had to be extracted.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\tHow long does a modern endodontic treatment take?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Usually one session.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t8. What benefits does laser have compared to classical methods?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Deeper disinfection, faster healing, reduced discomfort and risk of re-infection.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\tCan the laser be used on any tooth?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

Yes, the technology allows application on all types of teeth, including those with difficult access or complex anatomy.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\tHow long does a correctly endodontically treated tooth with a laser last?<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t

\u2028Just like a healthy natural tooth, if restored correctly and hygiene is maintained.<\/span><\/span><\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Index of Terms \u2013 Modern Endodontics<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Biofilm<\/b><\/span><\/span><\/span> \u2013 microscopic layer of bacteria organized in a protective matrix; it forms on the internal surfaces of tooth canals and is difficult to remove using conventional methods.<\/span><\/span><\/span><\/p>

Biocompatible<\/b><\/span><\/span><\/span> \u2013 a material or substance that is well-tolerated by the body, without causing adverse reactions.<\/span><\/span><\/span><\/p>

Bactericide<\/b><\/span><\/span><\/span> \u2013 an agent that destroys bacteria (as opposed to bacteriostatic, which merely inhibits them).<\/span><\/span><\/span><\/p>

Dentin tubules<\/b><\/span><\/span><\/span> \u2013 microchannels present in the dentin structure that connect the pulp chamber to the outside of the tooth; they can be pathways for bacteria.<\/span><\/span><\/span><\/p>

Cavitation<\/b><\/span><\/span><\/span> \u2013 a physical phenomenon produced by laser pulses in liquid (water), which generates vapor bubbles and negative pressure, facilitating the cleaning and disinfection of channels.<\/span><\/span><\/span><\/p>

Dig<\/b><\/span><\/span><\/span> \u2013 thin latex or similar material sheet, attached to the tooth with a clamp, to completely isolate it from the rest of the oral cavity during treatment.<\/span><\/span><\/span><\/p>

Root Canal Treatment<\/b><\/span><\/span><\/span> \u2013 a branch of dentistry that deals with the treatment of the inside of the tooth (pulp chamber and root canals).<\/span><\/span><\/span><\/p>

Hydroxyapatite<\/b><\/span><\/span><\/span> \u2013 natural mineral care constitutes the main component of enamel and dentin; absorbs Erbium laser energy.<\/span><\/span><\/span><\/p>

Magnify<\/b><\/span><\/span><\/span> technical term for the process of <\/span><\/span><\/span>optical zoom<\/b><\/span><\/span><\/span> through a microscope or magnifying glass, which allows the visualization of details invisible to the naked eye.<\/span><\/span><\/span><\/p>

Prosthetic restoration<\/b><\/span><\/span><\/span> \u2013 restoration of the endodontically treated tooth with a crown or other prosthetic element to restore its correct shape and function.

Author:
<\/strong><\/span><\/span><\/span>Dr. Thomas Mendel<\/strong> – Medic Dentist cu 20 Ani de experien\u021b\u0103 – Specializare \u00een Microscopia Endodontics Laser – LSO (Laser Safety Officer) AALZ Aachen Germany, Master in Laser Dentistry Competence S.F.U. Vienna<\/p>

\u00a0<\/strong><\/span><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

1. Izola\u021bia Endodon\u021bia modern\u0103 se desf\u0103\u0219oar\u0103 cu izolare, laser \u0219i magnificare.\u2028Dac\u0103 nu folosim izolare, nu putem vorbi despre endodon\u021bie propriu-zis\u0103, deoarece interiorul dintelui este contaminat cu s\u00e2nge \u0219i saliv\u0103 din cavitatea oral\u0103, care de\u021bine cea mai complex\u0103 flor\u0103 bacterian\u0103 a organismului uman. Izolarea se realizeaz\u0103 cu folia de dig\u0103 \u2013 o folie sub\u021bire de latex […]<\/p>\n","protected":false},"author":7,"featured_media":13957,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48],"tags":[117,118],"class_list":["post-13945","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-terapie-laser-stomatologica","tag-endodontia-moderna-izolare","tag-magnificare-si-laser"],"_links":{"self":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/13945","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/comments?post=13945"}],"version-history":[{"count":39,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/13945\/revisions"}],"predecessor-version":[{"id":14428,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/13945\/revisions\/14428"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/media\/13957"}],"wp:attachment":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/media?parent=13945"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/categories?post=13945"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/tags?post=13945"}],"curies":[{"name":"WordPress","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}