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Acidentes com hipoclorito de sódio durante o tratamento endodôntico
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| PPG_38839 | 229.88 KB | Adobe PDF |
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Abstract(s)
A endodontia evoluiu substancialmente nas últimas décadas. O desenvolvimento de novas tecnologias e materiais facilitam o trabalho do medico dentista e diminuem o tempo do tratamento endodôntico. Contudo, os insucessos estão relacionados diretamente com a persistência de microrganismos que resistem ao preparo químico-mecânico. A irrigação durante o tratamento endodôntico é, portanto, fundamental para que se consiga obter uma desinfeção adequada do sistema de canais radiculares. O objetivo principal do tratamento endodôntico (TE) é a eliminação de tecido pulpa, eliminação de bactérias do sistema de canais radiculares e evitar a reinfeção.
O tratamento endodôntico ocorre em várias etapas e uma delas, e de grande importância, é a irrigação. Entre as principais substâncias químicas auxiliares empregadas no procedimento de irrigação, destaca-se o hipoclorito de sódio (NaClO). Para tal, essa solução apresenta ação antimicrobiana, dissolve resíduos teciduais, promover a lubrificação facilitando a ação da instrumentação endodôntica e apresenta baixa toxicidade aos tecidos periapicais.
Esta substância tem sido amplamente utilizada no tratamento endodôntico na etapa de desinfeção dos canais. A sua concentração varia entre 0,5% a 5,25% dependendo da diluição e protocolo usado por cada profissional. Espera-se que essa solução irrigadora se restrinja ao espaço canalar, porém, quando o hipoclorito alcança os tecidos adjacentes, este contato pode ocasionar algumas reações de toxicidade. Evitar o uso indiscriminado do irrigante para prevenir os acidentes de NaOCl seria a melhor solução, porém muitas vezes não é possível impedi-lo.
O resultado acidental da extrusão do hipoclorito de sódio é imprevisível, sem nível definido em termos de concentração e volume, que determinam a gravidade dos sintomas do paciente. O reconhecimento precoce e manejo adequado dessas complicações pelo medico dentistas é essencial.
O objectivo deste trabalho de revisão é desta forma esclarecer os profissionais sobre sua importância e também das consequências que o material pode trazer se não usado corretamente, isto é, uma revisão da literatura em relação aos danos causados aos tecidos e ao paciente pelo extravasamento de hipoclorito de sódio durante a irrigação, etapa fundamental do tratamento endodôntico.
Endodontics has evolved substantially in the last decades. The development of new technologies and materials facilitates the work of the dentist and decreases the time of the endodontic treatment. However, the failures are directly related to the persistence of microorganisms that resist chemical-mechanical preparation. Irrigation during endodontic treatment is therefore essential to achieve adequate disinfection of the root canal system. The main goal of endodontic treatment (ET) is to eliminate pulp tissue, eliminate bacteria from the root canal system and prevent reinfection. Endodontic treatment occurs in several stages and one of them, and of great importance, is irrigation. Among the main auxiliary chemical substances used in the irrigation procedure is sodium hypochlorite (NaClO). For this, this solution presents antimicrobial action, dissolves tissue residues, promote lubrication facilitating the action of endodontic instrumentation and presents low toxicity to the periapical tissues. This substance has been widely used in endodontic treatment in the disinfection stage of the canals. Its concentration ranges from 0.5% to 5.25% depending on the dilution and protocol used by each professional. It is expected that this irrigating solution will be restricted to the canal space, but when the hypochlorite reaches adjacent tissues, this contact may cause some toxicity reactions. Avoiding the indiscriminate use of the irrigant to prevent NaOCl accidents would be the best solution, but often it is not possible to prevent it. The accidental result of sodium hypochlorite extrusion is unpredictable, with no level defined in terms of concentration and volume, which determines the severity of the patient's symptoms. Early recognition and proper management of these complications by dentists is essential. The aim of this review work is to clarify the professionals about its importance and also the consequences that the material can bring if not used correctly, that is to say, a review of the literature regarding the damages caused to the tissues and to the patient by the extravasation of hypochlorite of sodium during irrigation, a fundamental step of endodontic treatment.
Endodontics has evolved substantially in the last decades. The development of new technologies and materials facilitates the work of the dentist and decreases the time of the endodontic treatment. However, the failures are directly related to the persistence of microorganisms that resist chemical-mechanical preparation. Irrigation during endodontic treatment is therefore essential to achieve adequate disinfection of the root canal system. The main goal of endodontic treatment (ET) is to eliminate pulp tissue, eliminate bacteria from the root canal system and prevent reinfection. Endodontic treatment occurs in several stages and one of them, and of great importance, is irrigation. Among the main auxiliary chemical substances used in the irrigation procedure is sodium hypochlorite (NaClO). For this, this solution presents antimicrobial action, dissolves tissue residues, promote lubrication facilitating the action of endodontic instrumentation and presents low toxicity to the periapical tissues. This substance has been widely used in endodontic treatment in the disinfection stage of the canals. Its concentration ranges from 0.5% to 5.25% depending on the dilution and protocol used by each professional. It is expected that this irrigating solution will be restricted to the canal space, but when the hypochlorite reaches adjacent tissues, this contact may cause some toxicity reactions. Avoiding the indiscriminate use of the irrigant to prevent NaOCl accidents would be the best solution, but often it is not possible to prevent it. The accidental result of sodium hypochlorite extrusion is unpredictable, with no level defined in terms of concentration and volume, which determines the severity of the patient's symptoms. Early recognition and proper management of these complications by dentists is essential. The aim of this review work is to clarify the professionals about its importance and also the consequences that the material can bring if not used correctly, that is to say, a review of the literature regarding the damages caused to the tissues and to the patient by the extravasation of hypochlorite of sodium during irrigation, a fundamental step of endodontic treatment.
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Keywords
Sodium hypoclorite Irrigants Endodontic treatment NaOCl accidents Desinfection Management NaOCl accidents Root canals