Avaliação in vitro da eficácia da remoção da guta-percha no retratamento endodôntico por meio de microscopia operatória
DOI:
https://doi.org/10.21270/archi.v7i8.3120Resumo
Retratamento endodôntico é uma tentativa de restabelecimento da saúde dos tecidos periapicais devido um tratamento inadequado ou uma reinfecção dos canais obturados que foram acometidos por uma infiltração coronária ou apical. A remoção completa do material obturador é necessária para obter acesso ao forame, facilitando assim a limpeza e modelagem do sistema de canais radiculares. O objetivo deste estudo foi comparar in vitro a remoção da guta-percha com ou sem uso do solvente. Vinte e oito pré-molares unirradiculares foram instrumentados com sistema Reciproc e obturados por meio da técnica de condensação lateral. A remoção da guta-percha foi realizada de duas formas distintas, sendo as amostras divididas aleatoriamente em dois grupos: com (n=14) e sem solvente (n=14). Após o seccionamento dos espécimes, realizou-se a captura das imagens das raízes por meio de uma câmera fotográfica acoplada ao microscópio operatório. A mensuração da área de guta-percha remanescente foi realizada pelo programa AUTOCAD. O remanescente de guta-percha entre os grupos foi comparado por meio do teste Mann-Whitney (p<0,05). Após aplicação da técnica de desobturação, verificou-se que todas as amostras mostraram uma redução estatisticamente significante. Quando comparados os terços cervical (TC), médio (TM) e apical (TA) do canal radicular no terço apical foi verificado maior quantidade de remanescente de guta-percha em ambos os grupos estudados. Não houve diferença estatística significativa sobre o remanescente de guta-percha ao comparar os grupos com e sem solvente (p=0,546). Concluiu-se que o uso do solvente não melhorou a remoção de remanescente de guta-percha das paredes do canal radicular.Descritores: Endodontia; Guta-Percha; Retratamento; Dente.
Downloads
Referências
Stabholz A, Friedman S. Endodontic retreatment - case selection and technique. Part 2: Treatment planning for retreatment. J Endod. 1988; 14(12):607-14.
Barrieshi-Nusair KM. Gutta-percha retreatment: effectiveness of Nickel-Titanium rotary instruments versus stainless steel hand files. J Endod. 2002; 28(6):454-56.
Ruddle CJ. Nonsurgical retreatment. J Endod. 2004; 30(12):827-45.
Siqueira JF, Roças IN. Polymerase chain reaction–based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97(1):85-94.
Wilcox LR, Krell KV, Madison S, Rittman B.
Endodontic retreatment: Evaluation of gutta-percha and sealer removal and canal reinstrumentation. J Endod. 1987; 13(9):453-57.
Wilcox LR. Endodontic retreatment: ultrasonics and chloroform as the final step in reinstrumentation. J Endod. 1989; 15(3):125-28.
Friedman S, Stabholz A, Tamse A. Endodontic retreatment–case selection and technique. 3. Retreatment techniques. J Endod. 1990; 16(11):543-49.
Zakariasen KL, Boran T, Macdonald R. The emerging role for lasers in endodontics and other areas of dentistry. Alpha Omegan. 1990; 83(4):65-7.
Teplitsky EP, Rayner D, Chin I, Markowsky R. Gutta-percha removal utilizing GPX instrumentation. J Can Dent Assoc. 1992; 58(1):53-8.
Hulsmann M, Stotz S. Efficacy, cleaning ability and safety of different devices for gutta-percha removal in root canal retreatment. Int Endod J. 1997;30(4):227-33.
Fruchi LC, Ordinola-Zapata R, Cavenago BC, Hungaro MA, Bueno CE, De Martin AS. Efficacy of reciprocating instruments for removing filling material in curved canals obturated with a single cone technique: a micro-computed tomographic analysis. J Endod. 2014; 40(7):1000-4.
Bodrumlu E, Er O, Kayaoglu, G. Solubility of root canal sealers with different organic solvents. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(3):67-9.
Tasdemir T, Er K, Yildirim T, Celik D. Efficacy of three rotary NiTi instruments in removing gutta-percha from root canals. Int Endod J. 2008; 41(3):191-96.
Hunter KR, Doblecki W, Pelleu Jr GB. Halothane and eucalyptol as alternatives to chloroform for softening gutta-percha. J Endod. 1991; 17(7):310-11.
Kaplowitz GJ. Evaluation of the ability of essential oils to dissolve gutta-percha. J Endod. 1991; 17(9):448-9.
Ladley RW, Campbell AD, Hicks ML, Li SH. Effectiveness of halothane used with ultrasonics or hand instrumentation to remove gutta-percha from the root canal. J Endod. 1991; 17(5):221-4.
Kaplowitz GJ. Evaluation of gutta-percha solvents. J Endod.1990; 16(11):539-40.
Wourms DJ, Campbell AD, Hicks ML, Pelleu GB Jr, Alternative solventes to chloroform for gutta-percha removal. J Endod. 1990; 16(5):224-26.
Hansen MG. Relative efficiency of solvents used in endodontics. J Endod. 1998; 24(1):38-40.
Ribeiro D, Matsumoto MA, Marques ME, Salvadori DM. Biocompatibility of gutta-percha solvents using in vitro mammalian test-system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103(5):106-9.
Mushtaq M, Masoodi A, Farooq R, Yaqoob Khan F. The dissolving ability of different organic solvents on three different root canal sealers: In vitro study. Iran Endod J. 2012; 7(4):198-202.
Mandel E, Friedman S. Endodontic retreatment: a rational approach to root canal reinstrumentation. J Endod.1992; 18(11):565-69.
Rodig T, Reicherts P.; Konietschke F, Dullin C, Hahn W, Hulsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J. 2014; 47(10):942-8.
Masiero AV, Barletta FB. Effectiveness of different techniques for removing gutta-percha during retreatment. Int Endod J. 2005; 38(1):2-7.
Ezzie E, Fleury A, Solomon E, Spears R, He J. Efficacy of retreatment techniques for a resin based root canal obturation material. J Endod. 2006; 32(4):341-4.
Mollo A, Botti G, Principi GN, Randellini E, Paragliola R, Chazine M, Ounsi HF, Grandini S. Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals. Int Endod J. 2012; 45(1):1-6.
Ferreira JJ, Rhodes JS, Ford TR. The efficacy of gutta-percha removal using ProFiles. Int Endod J. 2001; 34(4):267-74.
Imura N, Kato AS, Hata GI, Uemura M, Toda T, Weine F. A comparison of the relative efficacies of four hand and rotary instrumentation techniques during endodontic retreatment. Int Endod J. 2000; 33(4):361-66.
Barletta FB, RAHDE Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto, G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007; 73(1):65.
Rodig T, Hausdorfer T, Konietschke F, Dullin C, Hahn W, Hulsmann M. Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals– a micro-computed tomography study. Int Endod J. 2012; 45(6):580-89.
Zuolo AS, Mello JE Jr, Cunha RS, Zuolo ML, Bueno CE. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J. 2013; 46(10):947-53.
Vidal FT, Nunes E, Horta MC, Freitas MR, Silveira FF. Evaluation of three different rotary systems during endodontic retreatment - Analysis by scanning electron microscopy. J Clin Exp Dent. 2016; 8(2):125-29.
Kim S, Baek S. The microscope and endodontics. Dent Clin North Am. 2004; 48(1):11-8.
Schirrmeister JF, Meyer KM, Hermanns P, Altenburger MJ, Wrbas KT. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J. 2006; 39(2):150-56.
Marques da Silva B, Baratto-Filho F, Leonardi DP, Henrique Borges A, Volpato L, Branco Barletta F. Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material. Int Endod J. 2012; 45(10):927-32.
Alves FR, Almeida BM, Neves MA, Moreno JO, Rôças IN, Siqueira-Junior JF. Disinfecting oval-shaped root canals: effectiveness of different supplementary approaches. J Endod. 2011; 37(4):496-501.
