Loading...
Publication
Como preservar estrutura dentária na remoção de instrumentos fraturados: sistemas de loop – revisão narrativa
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| Projeto de pós-graduação_39586 | 877.19 KB | Adobe PDF |
Advisor(s)
Abstract(s)
Atualmente, a introdução de sistemas de limas rotatórias de níquel-titânio (Ni-Ti) revelou não só as suas vantagens, como também alguns desafios durante a prática clínica. A fratura de instrumentos constitui uma complicação clínica que exige uma tomada de decisão relativamente ao tratamento e métodos a selecionar.
Em resposta a este acidente endodôntico surgiram diversas técnicas de remoção de instrumentos fraturados que, inevitavelmente, sacrificam a estrutura dentinária. Apesar de não existir um método padrão, a recuperação do instrumento com pontas ultrassónicas, em conjunto com o microscópio operatório, tem sido apontada como um método eficaz e seguro. No entanto, em alguns casos clínicos o fragmento permanece solto dentro do canal radicular, mesmo que se empregue a técnica de pontas ultrassónicas. Surgem, assim, os inovadores sistemas loop, os quais auxiliam a recuperação mecânica do fragmento através da sua apreensão.
Desta forma, nesta revisão narrativa, o intuito é responder à seguinte questão colocada: “Os novos sistemas loop permitem uma maior preservação da estrutura dentária, quando comparados com a técnica de ultrassons, na remoção de instrumentos fraturados?”.Materiais e Métodos: A pesquisa bibliográfica foi efetuada nos motores de pesquisa PubMed, ScienceDirect e Journal of Endodontics. Foram elaboradas seis combinações com as palavras-chave propostas com o objetivo de atingir o máximo de informação possível. Após a eliminação de duplicados e da leitura do título e abstract foram integrados 37 artigos científicos nesta dissertação de mestrado.Critérios de Inclusão e Exclusão: Os critérios de inclusão englobam estudos que permitem um conhecimento amplo dos sistemas loop, as suas indicações, constituição e funcionamento. Foram considerados artigos de revisão narrativa, revisão sistemática, meta-análise, caso clínico, estudos in vitro e livros. Foram ainda integrados três websites que permitem o conhecimento específico de três marcas distintas de sistemas loop.
Foram excluídos artigos relativos a outras áreas da Medicina que não sejam a Medicina Dentária. Foram rejeitados os artigos cujo idioma não seja o português ou inglês e publicados antes de 2014.
Currently, the introduction of the nickel-titanium (Ni-Ti) rotary file system has revealed not only its advantages, but also some challenges in clinical practice. Instrument fracture is a clinical complication that requires decisions regarding treatment and methods to be selected. In response to this endodontic accident, various techniques have been developed to remove fractured instruments, which inevitably sacrifice dentin structure. Although there is no standard method, instrument retrieval using ultrasonic tips in conjunction with the dental operating microscope has been identified as an effective and safe method. However, in some clinical cases, even when using the ultrasonic tip technique, the fragment remains loose in the root canal. This has led to the development of innovative loop systems that assist in mechanical retrieval of the fragment by grasping it. The aim of this narrative review is to answer the following question: “Do the new loop systems allow greater preservation of tooth structure compared to the ultrasonic technique in the removal of fractured instruments?” Materials and Methods: A bibliographic search was performed using the PubMed, ScienceDirect and Journal of Endodontics search engines. Six combinations were made with the suggested keywords to obtain as much information as possible. After eliminating duplicates and reading the title and abstract, 37 scientific articles were included in this master's thesis. Inclusion and Exclusion Criteria: The inclusion criteria include studies that provide a broad knowledge of loop systems, their indications, constitution, and function. Narrative review articles, systematic reviews, meta-analyses, clinical cases, in vitro studies, and books were included. Three websites were also included to provide specific knowledge about three different brands of loop systems. Articles in languages other than Portuguese and English and published before 2014 were rejected.
Currently, the introduction of the nickel-titanium (Ni-Ti) rotary file system has revealed not only its advantages, but also some challenges in clinical practice. Instrument fracture is a clinical complication that requires decisions regarding treatment and methods to be selected. In response to this endodontic accident, various techniques have been developed to remove fractured instruments, which inevitably sacrifice dentin structure. Although there is no standard method, instrument retrieval using ultrasonic tips in conjunction with the dental operating microscope has been identified as an effective and safe method. However, in some clinical cases, even when using the ultrasonic tip technique, the fragment remains loose in the root canal. This has led to the development of innovative loop systems that assist in mechanical retrieval of the fragment by grasping it. The aim of this narrative review is to answer the following question: “Do the new loop systems allow greater preservation of tooth structure compared to the ultrasonic technique in the removal of fractured instruments?” Materials and Methods: A bibliographic search was performed using the PubMed, ScienceDirect and Journal of Endodontics search engines. Six combinations were made with the suggested keywords to obtain as much information as possible. After eliminating duplicates and reading the title and abstract, 37 scientific articles were included in this master's thesis. Inclusion and Exclusion Criteria: The inclusion criteria include studies that provide a broad knowledge of loop systems, their indications, constitution, and function. Narrative review articles, systematic reviews, meta-analyses, clinical cases, in vitro studies, and books were included. Three websites were also included to provide specific knowledge about three different brands of loop systems. Articles in languages other than Portuguese and English and published before 2014 were rejected.
Description
Keywords
Endodontia Instrumento fraturado Sistema loop Pontas ultrassónicas BTR Pen EndoCowboy Terauchi File Removal Kit Propriedades mecânicas Endodontics Broken file Loop device Ultrasonic tips Mechanical properties