Abstract
Objetivo: avaliar o tratamento endodôntico (TE) e o retratamento não cirúrgico do canal radicular (RNCCR), associado a ampliação foraminal, realizado em sessão única. Material e Métodos: foram incluídos 125 dentes com periodontite apical e proservação de 6 a 12 meses. O sucesso foi considerado pela ausência de sinais e sintomas e reparo periapical completo ou incompleto. Análises de regressão logística foram utilizadas para identificar fatores associados ao reparo (p<0,05). Resultados: o TE mostrou 71,58% de cicatrização completa e 23,16% de cicatrização aceitável. O RNCCR mostrou 80% e 20% cicatrização completa e aceitável, respectivamente. Idade, sexo, tipo de tratamento e dor pré-operatória não foram estatisticamente significantes para o processo de cicatrização (p>0,05). Os pré-molares apresentaram a maior chance de reparo periapical. O cimento Pulp Canal Sealer mostrou maior chance de reparo periapical quando comparado ao Sealapex (p<0,05). Conclusão: o TE e RNCCR utilizando um protocolo de alargamento foraminal, proporcionaram um prognóstico favorável da cicatrização periapical
Highlights
Root canal treatment consists of the combination of mechanical instrumentation of the root canal system, its chemical debridement and filling with an inert material designed to maintain or restore the health of the periradicular tissue.[1]Current instrumentation and irrigation techniques are not completely effective in the elimination of debris and bacteria from the apical third due to the complex canal morphology, the narrow canal space, inadequate flushing of irrigants, and variation in the diameter and curvature of the root canals.[1]
The final sample consisted of clinical and radiographic findings of 125 teeth with the presence of periapical lesion of 114 patients aged 15-75 years. 95 teeth had a diagnosis of pulp necrosis and were submitted to primary root canal treatment and 30 teeth had previous endodontic treatment and were submitted to non-surgical root canal retreatment
Our study showed a greater chance of repair in premolars, followed by molars and anterior teeth corroborating with Chandra[26] that reported a higher success rate in teeth with 2 roots than in unirradicular teeth
Summary
Root canal treatment consists of the combination of mechanical instrumentation of the root canal system, its chemical debridement and filling with an inert material designed to maintain or restore the health of the periradicular tissue.[1]Current instrumentation and irrigation techniques are not completely effective in the elimination of debris and bacteria from the apical third due to the complex canal morphology, the narrow canal space, inadequate flushing of irrigants, and variation in the diameter and curvature of the root canals.[1]. Studies have observed the presence of bacteria in the apical foramen, with colonies extending to the extraradicular region in certain cases.[2]. These bacteria, if not eliminated, can survive owing to the constant supply of nutrition from the periapical area. To obtain adequate root canal disinfection and ensure a favorable environment for periapical healing, cleaning and shaping of the foramina region may be necessary.[2]. When primary root canal treatment fails, retreatment or apical surgery is often indicated. Ng et al.,[4] in meta-analyses, observed that the achievement of patency at the canal terminus and the extension of canal cleaning as close as possible to its apical terminus were conditions found to improve the periapical healing
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