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Descolagem de attachments ortodônticos com recurso a várias técnicas: um estudo-piloto
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| Projeto de pós-graduação_39694 | 6.11 MB | Adobe PDF |
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Abstract(s)
Os objetivos deste estudo são: comparar a eficácia de três métodos de remoção de attachments em compósito; determinar a quantidade de resina composta remanescente na superfície do esmalte após a remoção dos attachments e determinar as lesões produzidas no esmalte pelos diferentes tipos de técnicas de remoção de attachments: brocas multilaminadas em tungsténio de 8 lâminas, brocas Arkansas e brocas multilaminadas em tungsténio de 12 lâminas a baixa rotação.
Materiais e Métodos: No estudo, foram incluídos vinte e sete (N=27) dentes humanos extraídos por outras causas que não comprometimento coronário e, portanto, com superfícies vestibulares e linguais intactas e que foram adequadamente conservados em soro fisiológico à temperatura ambiente imediatamente após a extração para evitar a desidratação, até a data de início do estudo. Para colar os attachments na superfície do esmalte, foi utilizada uma resina composta fluida (Supreme Flowable Restorative - 3M Filtek™) e foi seguido o protocolo de colagem recomendado pelo fabricante. Após a colagem, os dentes foram novamente armazenados em saliva artificial em temperatura ambiente por 10 dias. Durante o procedimento de remoção, o tempo necessário para remover o compósito com cada um dos três métodos foi medido com um cronómetro, com um limite de tempo de 45 segundos. Após a remoção dos attachments, procedeu-se à quantificação da quantidade de compósito remanescente aderido à superfície do dente e à análise da presença/ausência de lesões de esmalte induzidas pelas diferentes técnicas de remoção. Para avaliar o índice de adesivo remanescente (IAR), foi utilizada a classificação descrita por Artun e Bergland (1984). Para avaliar o índice de rugosidade superficial (IRS), foi utilizada a classificação descrita por Howell e Weekes (1990).
Resultados: O IAR e a técnica utilizada têm uma associação significativa, indicando diferenças no índice de adesivo remanescente conforme a técnica. A broca multilaminada em tungsténio com 8 lâminas teve o menor IAR (IAR 0 - 81,5%). IRS e técnica utilizada também têm uma associação significativa, mostrando diferenças na rugosidade superficial do esmalte. A broca multilaminada em tungsténio de 8 lâminas teve o maior IRS (IRS 2 - 48,1%). O tempo de remoção dos dispositivos varia significativamente com a técnica. A técnica mais rápida foi a de tungsténio com 8 lâminas (32,9 segundos).
Conclusões: Dentro dos limites impostos pelo tipo de estudo, foi possível concluir que as estrias e lesões no esmalte são inevitáveis, independentemente do método utilizado para remover o attachment. As brocas Arkansas, quando usadas em baixa rotação com abundante refrigeração, podem ser consideradas o método mais conveniente porque, em comparação com as multilaminadas de 8 e 12 lâminas, provaram ser as menos agressivas e resultam na menor formação de estrias e lesões na superfície do esmalte. Ao comparar a eficácia dos três métodos de remoção dos attachments após o tratamento ortodôntico, através da avaliação do IAR após o uso de cada método durante um limite de tempo de 45 segundos, verificou-se que as brocas multilaminadas em tungsténio com 8 lâminas, montadas em contra-ângulo em baixa rotação, são as mais eficientes e rápidas, porém também as que causam mais estrias e lesões na superfície do esmalte (média de IRS 2).
The objectives of this study are to compare the efficacy of three methods for removing composite attachments, determine the amount of composite resin remaining on the enamel surface after removal, and assess the lesions produced on the enamel by different removal techniques: tungsten multilaminated bur with 8 blades, Arkansas burs, and tungsten multilaminated bur with 12 blades at low rotation. Materials and Methods: The study included twenty-seven (N=27) extracted human teeth, which were removed for reasons other than coronal compromise and, therefore, had intact buccal and lingual surfaces. These teeth were properly preserved in saline solution at room temperature immediately after extraction to prevent dehydration until the study's initiation. To bond the attachments to the enamel surface, a fluid composite resin (Supreme Flowable Restorative - 3M Filtek™) was used, following the manufacturer's recommended bonding protocol. After bonding, the teeth were stored again in artificial saliva at room temperature for 10 days. During the removal procedure, the time required to remove the composite using each of the three methods was measured with a stopwatch, with a time limit of 45 seconds. After attachment removal, the remaining composite was quantified on the tooth surface, and the presence/absence of enamel lesions induced by the different removal techniques was analyzed. The adhesive remnant index (ARI) was evaluated using the classification described by Artun and Bergland (1984). The surface roughness index (SRI) was assessed using the classification described by Howell and Weekes (1990). Results: ARI and the technique used have a significant association, indicating differences in the adhesive remnant index depending on the technique. The tungsten multilaminated bur with 8 blades had the lowest ARI (ARI 0 - 81.5%). SRI and technique used also have a significant association, showing differences in enamel surface roughness. The tungsten multilaminated bur with 8 blades had the highest SRI (SRI 2 - 48.1%). The removal time of the devices varies significantly with the technique. The fastest technique was tungsten with 8 blades (32.9 seconds). Conclusions: Within the limitations imposed by the study type, it was possible to conclude that enamel striations and lesions are inevitable, regardless of the method used to remove the attachment. Arkansas burs, when used at low speed with abundant cooling, can be considered the most convenient method because, compared to the multilaminated burs with 8 and 12 blades, they proved to be the least aggressive and resulted in the least formation of striations and lesions on the enamel surface. When comparing the effectiveness of the three methods for removing attachments after orthodontic treatment, through ARI evaluation after using each method within a 45-second limit, it was found that tungsten carbide multilaminated burs with 8 blades, mounted in a contra-angle at low speed, are the most efficient and quickest but also cause the most striations and lesions on the enamel surface (average SRI 2).
The objectives of this study are to compare the efficacy of three methods for removing composite attachments, determine the amount of composite resin remaining on the enamel surface after removal, and assess the lesions produced on the enamel by different removal techniques: tungsten multilaminated bur with 8 blades, Arkansas burs, and tungsten multilaminated bur with 12 blades at low rotation. Materials and Methods: The study included twenty-seven (N=27) extracted human teeth, which were removed for reasons other than coronal compromise and, therefore, had intact buccal and lingual surfaces. These teeth were properly preserved in saline solution at room temperature immediately after extraction to prevent dehydration until the study's initiation. To bond the attachments to the enamel surface, a fluid composite resin (Supreme Flowable Restorative - 3M Filtek™) was used, following the manufacturer's recommended bonding protocol. After bonding, the teeth were stored again in artificial saliva at room temperature for 10 days. During the removal procedure, the time required to remove the composite using each of the three methods was measured with a stopwatch, with a time limit of 45 seconds. After attachment removal, the remaining composite was quantified on the tooth surface, and the presence/absence of enamel lesions induced by the different removal techniques was analyzed. The adhesive remnant index (ARI) was evaluated using the classification described by Artun and Bergland (1984). The surface roughness index (SRI) was assessed using the classification described by Howell and Weekes (1990). Results: ARI and the technique used have a significant association, indicating differences in the adhesive remnant index depending on the technique. The tungsten multilaminated bur with 8 blades had the lowest ARI (ARI 0 - 81.5%). SRI and technique used also have a significant association, showing differences in enamel surface roughness. The tungsten multilaminated bur with 8 blades had the highest SRI (SRI 2 - 48.1%). The removal time of the devices varies significantly with the technique. The fastest technique was tungsten with 8 blades (32.9 seconds). Conclusions: Within the limitations imposed by the study type, it was possible to conclude that enamel striations and lesions are inevitable, regardless of the method used to remove the attachment. Arkansas burs, when used at low speed with abundant cooling, can be considered the most convenient method because, compared to the multilaminated burs with 8 and 12 blades, they proved to be the least aggressive and resulted in the least formation of striations and lesions on the enamel surface. When comparing the effectiveness of the three methods for removing attachments after orthodontic treatment, through ARI evaluation after using each method within a 45-second limit, it was found that tungsten carbide multilaminated burs with 8 blades, mounted in a contra-angle at low speed, are the most efficient and quickest but also cause the most striations and lesions on the enamel surface (average SRI 2).
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Keywords
Attachments ortodônticos Remoção de attachments Brocas multilaminadas em tungsténio Brocas Arkansas Erosão do esmalte Orthodontic attachments Attachments removal Tungsten multilaminated burs Arkansas burs Enamel erosion