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Comparação da eficácia de diferentes técnicas de cirurgia apical
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Abstract(s)
É evidente que a Medicina Dentária evoluiu de forma exponencial no decorrer dos últimos anos. Esta deu-se a nível de todas as suas vertentes e, entre elas, a área da endodontia e da cirurgia, que acompanharam essa evolução não só a nível técnico e dos materiais disponíveis, como também a nível do seu armamentário. Este processo evolutivo traduziu-se, por exemplo, num aumento significativo da eficácia e consequente sucesso do tratamento endodôntico. Embora existam relatos de taxas de sucesso superiores a 90%, podem existir complicações que levam ao insucesso do tratamento convencional e à consequente necessidade de uma nova intervenção endodôntica ou de uma intervenção cirúrgica complementar.
A cirurgia apical surgiu há várias décadas como tentativa de resolução destas situações em que a patologia periapical persiste mesmo após o tratamento endodôntico convencional e do retratamento endodôntico sequencial. Desde então, esta prática tem vindo a evoluir. Foram introduzidas novas técnicas e materiais que abrangem desde o uso de microscópios e pontas ultrassónicas, a novos materiais de obturação e selamento apical mais biocompatíveis.
Não podendo excluir os motivos pelos quais se realiza este procedimento, esta monografia abordará também, de forma detalhada, as indicações e contraindicações pelas quais nos devemos reger a fim de melhorar o prognóstico deste tipo de intervenções.
As diferentes técnicas de cirurgia apical incluem a curetagem periapical, a apicectomia, a apicectomia com obturação retrógrada e a técnica de obturação canalar simultânea ao ato cirúrgico. Segundo a literatura, estas diferentes técnicas podem ser executadas de modo isolado ou agregadas num processo sequencial de protocolo clínico.
Deste modo, este trabalho tem como objetivo comparar a eficácia de diferentes técnicas de cirúrgica endodôntica apical.
When regarding dentistry, it’s evident it has undergone an exponential growth throughout the last years. This process involved all its aspects and among them, the surgical and endodontics fields as well, not only concerning the technical level or the materials available, but also when it comes to the armamentarium in general. These improvements resulted, for instance, in a substantial increase of effectiveness and consequent success of endodontic treatments. Despite the attested success rates of more than 90%, there may be complications that lead to failure of these conservative therapeutic methods, implying the need for a new endodontic intervention or a complementary surgical intervention. Apical surgery emerged several decades ago as an attempt to solve situations in which periapical pathology persisted even after conventional endodontic treatment and the sequential endodontic retreatment. Since then, this practice has been evolving. New techniques and materials have been introduced ranging from the use of microscopes and ultrasonic tips to new, more biocompatible, apical filling and sealing materials. Precluded of excluding the motifs for the performance of this procedure, this work also thoroughly addresses the indications and contraindications by which we must be governed to improve the prognosis on this type of intervention. The different techniques of apical surgery include periapical curettage, apicectomy, apicectomy with retrograde filling and the endodontic surgical intervention with simultaneous orthograde obturation technique. According to the literature, these different techniques can be performed independently or incorporated to a sequential process of clinical protocol. Highlighting that the success rates for endodontic surgery varies between 59% and 94%. This monography aims to compare the efficacy of different apical endodontic surgical techniques.
When regarding dentistry, it’s evident it has undergone an exponential growth throughout the last years. This process involved all its aspects and among them, the surgical and endodontics fields as well, not only concerning the technical level or the materials available, but also when it comes to the armamentarium in general. These improvements resulted, for instance, in a substantial increase of effectiveness and consequent success of endodontic treatments. Despite the attested success rates of more than 90%, there may be complications that lead to failure of these conservative therapeutic methods, implying the need for a new endodontic intervention or a complementary surgical intervention. Apical surgery emerged several decades ago as an attempt to solve situations in which periapical pathology persisted even after conventional endodontic treatment and the sequential endodontic retreatment. Since then, this practice has been evolving. New techniques and materials have been introduced ranging from the use of microscopes and ultrasonic tips to new, more biocompatible, apical filling and sealing materials. Precluded of excluding the motifs for the performance of this procedure, this work also thoroughly addresses the indications and contraindications by which we must be governed to improve the prognosis on this type of intervention. The different techniques of apical surgery include periapical curettage, apicectomy, apicectomy with retrograde filling and the endodontic surgical intervention with simultaneous orthograde obturation technique. According to the literature, these different techniques can be performed independently or incorporated to a sequential process of clinical protocol. Highlighting that the success rates for endodontic surgery varies between 59% and 94%. This monography aims to compare the efficacy of different apical endodontic surgical techniques.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Cirurgia apical endodôntica Apicectomia Macrocirurgia endodôntica e microcirurgia endodôntica