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Abordagem terapĂȘutica de dentes com metamorfose calcificante : o estado da arte e perspetivas futuras
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| 8.86 MB | Adobe PDF |
Authors
Abstract(s)
A metamorfose calcificante, também designada por calcificação do canal radicular ou obliteração do canal radicular (OCR), caracteriza-se pela deposição gradual de tecido duro no interior do espaço pulpar. Este processo pode ter um caråcter fisiológico, associado ao envelhecimento, ou reparador, caso seja iniciado por uma reação inflamatória da polpa.
O crescimento progressivo das calcificaçÔes pulpares reduz o lĂșmen dos canais afetados, tornando a sua localização uma tarefa desafiante e aumenta consideravelmente a complexidade do tratamento endodĂŽntico. A American Association of Endodontics (AAE) considera o tratamento destes dentes um procedimento de elevada dificuldade, sendo que a presença de calcificaçÔes aumenta significativamente a ocorrĂȘncia de acidentes iatrogĂ©nicos.
O surgimento de mĂ©todos inovadores tem permitido aumentar a segurança e a taxa de sucesso do tratamento destes casos. Uma abordagem endodĂŽntica conservadora e mais previsĂvel tornou-se possĂvel devido ao desenvolvimento contĂnuo da Endodontia Digital e Ă aplicação cada vez mais variada da CBCT, CAD-CAM e scanners intra-orais. TĂ©cnicas inovadoras como a Endodontia Guiada, a Realidade Aumentada e a InteligĂȘncia Artificial representarĂŁo, provavelmente, mais um passo na evolução do tratamento destes dentes.
Neste contexto, a presente revisĂŁo narrativa tem como objetivo evidenciar a prevalĂȘncia e o impacto das calcificaçÔes pulpares no tratamento endodĂŽntico, com um foco particular no potencial da Endodontia Guiada. Pretende-se, adicionalmente, destacar as perspetivas futuras do tratamento endodĂŽntico de dentes calcificados e enfatizar a importĂąncia dos desenvolvimentos mais recentes para a evolução da Endodontia.
Calcific metamorphosis, also known as root canal calcification or pulp canal obliteration (PCO), is characterised by the gradual deposition of hard tissue inside the pulp space. This process can be physiological, associated with aging processes, or reparative, if it is initiated by an inflammatory reaction of the pulp. The progressive growth of pulp calcifications results in a reduction in the lumen of the affected canals, making localization a challenging task and considerably increasing the complexity of endodontic treatment. The American Association of Endodontics (AAE) considers the treatment of these teeth to be a highly difficult procedure, and the presence of calcifications significantly increases the occurrence of iatrogenic accidents. The emergence of innovative methods has made it possible to increase the safety and success rate of treatment in these cases. A conservative and more predictable endodontic approach has become possible due to the continuous development of Digital Endodontics and the increasingly varied application of CBCT, CAD-CAM and intraoral scanners. Innovative techniques such as Guided Endodontics, Augmented Reality and Artificial Intelligence will probably represent a further step in the evolution of the treatment of these teeth. In this context, this narrative review aims to highlight the prevalence and impact of pulp calcification on endodontic treatment, with a particular focus on the potential of Guided Endodontics. It also aims to highlight the future prospects for endodontic treatment of calcified teeth and to emphasise the importance of the latest developments for the evolution of endodontics.
Calcific metamorphosis, also known as root canal calcification or pulp canal obliteration (PCO), is characterised by the gradual deposition of hard tissue inside the pulp space. This process can be physiological, associated with aging processes, or reparative, if it is initiated by an inflammatory reaction of the pulp. The progressive growth of pulp calcifications results in a reduction in the lumen of the affected canals, making localization a challenging task and considerably increasing the complexity of endodontic treatment. The American Association of Endodontics (AAE) considers the treatment of these teeth to be a highly difficult procedure, and the presence of calcifications significantly increases the occurrence of iatrogenic accidents. The emergence of innovative methods has made it possible to increase the safety and success rate of treatment in these cases. A conservative and more predictable endodontic approach has become possible due to the continuous development of Digital Endodontics and the increasingly varied application of CBCT, CAD-CAM and intraoral scanners. Innovative techniques such as Guided Endodontics, Augmented Reality and Artificial Intelligence will probably represent a further step in the evolution of the treatment of these teeth. In this context, this narrative review aims to highlight the prevalence and impact of pulp calcification on endodontic treatment, with a particular focus on the potential of Guided Endodontics. It also aims to highlight the future prospects for endodontic treatment of calcified teeth and to emphasise the importance of the latest developments for the evolution of endodontics.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitårio Egas Moniz
Keywords
Metamorfose calcificante Calcificação pulpar Endodontia guiada Planeamento digital