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Abordagem do tratamento endodôntico não cirúrgico na presença de fraturas horizontais radiculares: revisão narrativa
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| Projeto de pós-graduação_2022100288 | 1.53 MB | Adobe PDF |
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Abstract(s)
As fraturas radiculares horizontais resultam de uma força de alta intensidade dirigida à raiz do dente, podendo envolver estruturas como a polpa, dentina e cemento, sendo o seu tratamento considerado um desafio para os profissionais de medicina dentária.Entre as complicações relacionadas com esta condição clínica, por norma associada a uma situação de trauma, podem-se destacar a necrose pulpar, reabsorção radicular externa e interna, inflamação periapical e perda do dente. No entanto, a realização do tratamento endodôntico em dentes com fraturas horizontais pode ser complicada devido às características anatómicas e à complexidade da lesão. Além disso, o sucesso do tratamento pode depender de vários fatores, como a técnica de instrumentação radicular utilizada e o tipo de material de obturação canalar. O objetivo proposto neste trabalho foi realizar uma revisão narrativa da literatura, avaliando o tratamento endodôntico não cirúrgico em dentes com presença de fraturas horizontais assim como os melhores materiais para promover o seu selamento. Foi realizada uma pesquisa bibliográfica em artigos científicos e, publicados nos últimos dez anos, em inglês e português, os motores de busca utilizados foram PubMed/NCBI, Cochrane Library e Science Direct, com as seguintes palavras-chave: (Endodontic treatment) AND (Horizontal root fracture) AND (root canal filling). Foram incluídos estudos clínicos, relatos de caso e estudos clínicos retrospectivos. Como critérios de exclusão os estudos realizados em animais, assim como artigos que não se adequaram ao tema proposto. Na literatura estão descritos vários estudos nos quais é possível verificar a importância de uma correta abordagem clínica e radiográfica das fraturas radiculares horizontais. A Tomografia Computadorizada de Feixe Cônico (CBCT) constitui o método de imagem mais útil na identificação, fornecendo uma melhor visualização do defeito. A terapia endodôntica apenas do fragmento coronal demonstrou ser suficiente, apresentando bons prognósticos. O Agregado de Trióxido de Mineral (MTA) e os cimentos endodônticos à base de silicato de cálcio são os materiais mais utilizados durante o tratamento dos dentes com fratura radicular horizontal, entretanto, estão descritos estudos nos quais não foi possível estabelecer uma diferença na taxa de sucesso do tratamento entre estes dois materiais, sendo necessário a realização de mais estudos comparativos com maior tempo de proservação.
Horizontal root fractures result from a high-intensity force directed at the root of the tooth, which can involve structures such as the pulp, dentin and cementum, and their treatment is considered a challenge for dental professionals. Among the complications related to this clinical condition, usually associated with a trauma situation, pulp necrosis, external and internal root resorption and periapical inflammation and tooth loss can be highlighted. However, performing endodontic treatment on teeth with horizontal fractures can be complicated due to the anatomical characteristics and complexity of the lesion. Furthermore, the success of the treatment may depend on several factors, such as the root instrumentation technique used and the type of canal filling material. The objective proposed in this work was to carry out a narrative review of the literature, evaluating non-surgical endodontic treatment in teeth with horizontal fractures as well as the best materials to promote their sealing. A bibliographical search was carried out on scientific articles published in the last ten years, in English and Portuguese, the search engines used were PubMed/NCBI, Cochrane Library and Science Direct, with the following keywords: (Endodontic treatment) AND (Horizontal root fracture) AND (root canal filling). Clinical studies, case reports and retrospective clinical studies were included. Studies carried out on animals were excluded, as well as articles that did not fit the proposed theme. Several studies are described in the literature in which it is possible to verify the importance of a correct clinical and radiographic approach to horizontal root fractures. Cone Beam Computed Tomography (CBCT) is the most useful imaging method for identification, providing a better visualization of the defect. Endodontic therapy of just the coronal fragment proved to be sufficient, with good prognosis. Mineral Trioxide Aggregate (MTA) and endodontic cements based on calcium silicate are the most used materials during the treatment of teeth with horizontal root fractures, however, studies are described in which it was not possible to establish a difference in the rate of success of the treatment between these two materials, making it necessary to carry out more comparative studies with longer follow-up times.
Horizontal root fractures result from a high-intensity force directed at the root of the tooth, which can involve structures such as the pulp, dentin and cementum, and their treatment is considered a challenge for dental professionals. Among the complications related to this clinical condition, usually associated with a trauma situation, pulp necrosis, external and internal root resorption and periapical inflammation and tooth loss can be highlighted. However, performing endodontic treatment on teeth with horizontal fractures can be complicated due to the anatomical characteristics and complexity of the lesion. Furthermore, the success of the treatment may depend on several factors, such as the root instrumentation technique used and the type of canal filling material. The objective proposed in this work was to carry out a narrative review of the literature, evaluating non-surgical endodontic treatment in teeth with horizontal fractures as well as the best materials to promote their sealing. A bibliographical search was carried out on scientific articles published in the last ten years, in English and Portuguese, the search engines used were PubMed/NCBI, Cochrane Library and Science Direct, with the following keywords: (Endodontic treatment) AND (Horizontal root fracture) AND (root canal filling). Clinical studies, case reports and retrospective clinical studies were included. Studies carried out on animals were excluded, as well as articles that did not fit the proposed theme. Several studies are described in the literature in which it is possible to verify the importance of a correct clinical and radiographic approach to horizontal root fractures. Cone Beam Computed Tomography (CBCT) is the most useful imaging method for identification, providing a better visualization of the defect. Endodontic therapy of just the coronal fragment proved to be sufficient, with good prognosis. Mineral Trioxide Aggregate (MTA) and endodontic cements based on calcium silicate are the most used materials during the treatment of teeth with horizontal root fractures, however, studies are described in which it was not possible to establish a difference in the rate of success of the treatment between these two materials, making it necessary to carry out more comparative studies with longer follow-up times.
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Keywords
Tratamento endodôntico Fraturas radiculares horizontais Materiais de preenchimento radicular Endodontic treatment Horizontal root fracture Root canal filling