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Tratamento restaurador atraumático: revisão dos aspetos clínicos
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A procura de alternativas à extração de dentes com lesão de cárie em locais ou casos em que a Medicina Dentária convencional não está disponível foi o impulsionador do desenvolvimento do Tratamento Restaurador Atraumático (TRA). O seu objetivo principal é a prevenção do desenvolvimento de lesão de cárie, bem como parar a sua progressão. Assim, esta técnica associa selantes (para selar fissuras e sulcos susceptíveis de desenvolver lesões de cárie) e restaurações (para restaurar cavidades que apresentem lesão de cárie em dentina) à instrução e motivação para a saúde oral. Uma das suas particularidades é ser realizada apenas com instrumentos manuais e com materiais adesivos, sendo assim possível executá-la em locais sem água ou eletricidade. A técnica consiste na seleção de casos de acordo com os critérios TRA, remoção manual de tecido cariado, restauração com recurso a materiais adesivos (ionómero de vidro convencional ou reforçado por resina e resina composta), com a execução concomitante de um selante protegendo sulcos e fissuras adjacentes pela Press Finger Technique. Fatores clínicos, como o isolamento relativo, sensibilidade clínica na remoção de cárie, manipulação do material, etc., são condicionantes do sucesso da técnica. Apresenta como desvantagens, por exemplo, as condições de realização, o tempo de execução, desvantagens inerentes aos materiais e o seu limitado desconhecimento e não aceitação relativa pela Medicina Dentária. Este trabalho pretende ser uma revisão bibliográfica da informação disponível sobre o Tratamento Restaurador Atraumático, no que respeita fundamentalmente a parte clínica da técnica, indicações, procedimentos, longevidade e considerações.
The search for alternatives to the extraction of cavitated teeth in places or cases without access to conventional Medical Dentistry was the reason for the development of the Atraumatic Restorative Treatment (ART). Its main goal is the prevention of the development of carious lesions, as well as to stop its progression. This technique associates sealers (sealing fissures and pits susceptible of developing carious lesions) and restorations (restoring cavities that present carious lesion at the dentine level) to the education and motivation for oral health. One of its characteristics is that it is only completed with manual instruments and adhesive materials, thus being possible to perform it in places without water or electricity. The technique consists on the selection of cases according to the criteria of ART, the manual removal of carious tissue, the restoration with adhesive materials (conventional or resin modified glass ionomer, or composite), with the simultaneous execution of a sealer that protects the adjacent pits and fissures by the Press Finger Technique. Clinical factors such as relative isolation, clinical sensitivity when removing the carious lesion, the manipulation of the material, etc. affect the technique’s success. It presents disadvantages, as for example, the execution conditions, the time of concluding, the disadvantages inherent to the materials and lack of knowledge about it and relative acceptance in Medical Dentistry. This work aims to make a review of the available information on TRA, especially regarding the clinical part of the technique, indications, procedures, survival and considerations.
The search for alternatives to the extraction of cavitated teeth in places or cases without access to conventional Medical Dentistry was the reason for the development of the Atraumatic Restorative Treatment (ART). Its main goal is the prevention of the development of carious lesions, as well as to stop its progression. This technique associates sealers (sealing fissures and pits susceptible of developing carious lesions) and restorations (restoring cavities that present carious lesion at the dentine level) to the education and motivation for oral health. One of its characteristics is that it is only completed with manual instruments and adhesive materials, thus being possible to perform it in places without water or electricity. The technique consists on the selection of cases according to the criteria of ART, the manual removal of carious tissue, the restoration with adhesive materials (conventional or resin modified glass ionomer, or composite), with the simultaneous execution of a sealer that protects the adjacent pits and fissures by the Press Finger Technique. Clinical factors such as relative isolation, clinical sensitivity when removing the carious lesion, the manipulation of the material, etc. affect the technique’s success. It presents disadvantages, as for example, the execution conditions, the time of concluding, the disadvantages inherent to the materials and lack of knowledge about it and relative acceptance in Medical Dentistry. This work aims to make a review of the available information on TRA, especially regarding the clinical part of the technique, indications, procedures, survival and considerations.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2012
Palavras-chave
Endodontia Teses de mestrado - 2012