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Avaliação da eficácia da remoção de tecido pulpar em função do tipo de abertura coronária
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Introdução: A abertura coronária é uma das etapas mais importantes do tratamento endodôntico, influenciando diretamente a execução das etapas subsequentes. Atualmente, existem duas abordagens descritas a abertura coronária tradicional (ACT) e a abertura coronária minimamente invasiva (ACMi). O objetivo deste estudo foi avaliar se o tipo de abertura utilizado causa diferenças a nível da remoção de tecido pulpar durante o tratamento endodôntico.
Materiais e métodos: 17 pré-molares monorradiculares, armazenados em formol tamponado após extração, foram divididos em dois grupos. No grupo 1 (G1) foram feitas ACT, enquanto que no grupo 2 (G2) foram feitas ACMi. De seguida, todos os dentes foram instrumentados com limas Hyflex seguindo o mesmo protocolo de instrumentação e irrigação. Os procedimentos clínicos foram cronometrados. Os dentes foram, na etapa seguinte, descalcificados, cortados e corados. Os cortes histológicos foram visualizados e fotografados no microscópio ótico e analisados no software ImageJ medindo assim a eficácia da instrumentação.
Resultados: Os resultados da eficácia da instrumentação foram superiores a 94% nos dois grupos. O G2 teve uma instrumentação mais eficaz no terço apical, enquanto que a instrumentação mais eficaz dos terços médio e coronal foram no G1. As diferenças observadas intra-grupos e em cada terço não foram estatisticamente significativas. Quanto à duração da abertura coronária, instrumentação e totalidade do procedimento a média destas foi inferior para o G2. No entanto, as diferenças só foram estatisticamente significativas para a primeira. Não se verificaram fraturas de instrumentos.
Conclusão: Os resultados sugerem que a eficácia da instrumentação é semelhante entre ACT e ACMi, sendo necessários mais estudos sobre este tópico. Quanto à duração dos procedimentos, apesar da execução da ACMi ser mais rápida isto não se reflete na duração da totalidade do procedimento.
Introduction: The access cavity is one of the most important stages of endodontic treatment, directly influencing the execution of the following stages. Nowadays, there are two approaches described the traditional access cavity (ACT) and the minimally invasive access cavity (ACMi). The purpose of this study was to evaluate if the type of access cavity caused any differences in the removal of pulpal tissue during the endodontic treatment. Methods: 17 mono-radicular premolars, stored in Formalin after the extraction, were assigned to two groups. In group 1 (G1) we did ACT, whereas in group 2 (G2) we did ACMi. Following that, each tooth was instrumented with Hyflex files with the same protocol for instrumentation and irrigation. All clinical procedures were timed. In the next stage the teeth were decalcified, cut and coloured. The histologic samples were visualised and photographed with an optic microscope and analysed with ImageJ software, measuring the instrumentation efficacy. Results: The results for the instrumentation efficacy were superior to 94% in both groups. G2 had a more efficient instrumentation in the apical third, whilst G1 had more efficacy in instrumentation of the middle and coronal thirds. The differences seen in each group and in each third were not statistically significant. In terms of duration of coronary access, instrumentation and the full procedure the mean values were lower in G2. However, the differences were only statistically different for the duration of the coronary access. There was no occurrence of broken instruments. Conclusion: The results suggest that the efficacy of the instrumentation is similar between groups, so more studies about this topic are necessary. When it comes to the duration of the procedures, even though the ACMi execution is faster that doesn’t reflect on the duration of the entirety of the procedure.
Introduction: The access cavity is one of the most important stages of endodontic treatment, directly influencing the execution of the following stages. Nowadays, there are two approaches described the traditional access cavity (ACT) and the minimally invasive access cavity (ACMi). The purpose of this study was to evaluate if the type of access cavity caused any differences in the removal of pulpal tissue during the endodontic treatment. Methods: 17 mono-radicular premolars, stored in Formalin after the extraction, were assigned to two groups. In group 1 (G1) we did ACT, whereas in group 2 (G2) we did ACMi. Following that, each tooth was instrumented with Hyflex files with the same protocol for instrumentation and irrigation. All clinical procedures were timed. In the next stage the teeth were decalcified, cut and coloured. The histologic samples were visualised and photographed with an optic microscope and analysed with ImageJ software, measuring the instrumentation efficacy. Results: The results for the instrumentation efficacy were superior to 94% in both groups. G2 had a more efficient instrumentation in the apical third, whilst G1 had more efficacy in instrumentation of the middle and coronal thirds. The differences seen in each group and in each third were not statistically significant. In terms of duration of coronary access, instrumentation and the full procedure the mean values were lower in G2. However, the differences were only statistically different for the duration of the coronary access. There was no occurrence of broken instruments. Conclusion: The results suggest that the efficacy of the instrumentation is similar between groups, so more studies about this topic are necessary. When it comes to the duration of the procedures, even though the ACMi execution is faster that doesn’t reflect on the duration of the entirety of the procedure.
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Saúde oral Teses de mestrado - 2019