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Publication
Técnicas de irrigação em endodontia : uma revisão narrativa
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Advisor(s)
Abstract(s)
A irrigação no tratamento endodôntico desempenha um papel fundamental na limpeza e desinfeção do sistema de canais radiculares, cuja anatomia dos mesmos se apresenta, hoje em dia, como um dos maiores obstáculos a essa desinfeção. A limpeza química e a desinfeção são etapas essenciais para a eliminação de infeções durante o tratamento do canal radicular.
É neste contexto que surge a preparação mecânica dos canais radiculares, durante o tratamento endodôntico, visando providenciar espaço para os irrigantes atuarem. Contudo, a produção de smear layer e detritos de dentina, erros iatrogénicos, enfraquecimento da estrutura da raiz e formação de fissuras apicais continuam a ser desvantagens da instrumentação dos canais radiculares, fazendo com que uma técnica sem instrumentação fosse o método ideal para a limpeza e desinfeção do sistema de canais radiculares (Şen et al., 1995; Gorni & Gagliani, 2004; Wu et al., 2000; Shemesh et al., 2006).
Os objetivos da irrigação do sistema de canais radiculares são a dissolução e a remoção de tecido pulpar, detritos dentinários, smear layer, microrganismos e seus derivados das paredes do canal radicular, garantindo a sua eliminação do sistema de canais radiculares. Existem atualmente diversos métodos e sistemas de irrigação que pretendem alcançar estes objetivos e ultrapassar os obstáculos quer da anatomia do sistema de canais radiculares quer da contaminação bacteriana dos mesmos.
Atualmente, a irrigação tradicional com agulha e seringa permanece como a mais empregue na prática clínica e durante o tratamento endodontico (Dutner et al., 2012; Savani et al., 2014;).
Contudo, a busca pela melhoria da segurança e eficácia da irrigação levou ao desenvolvimento de outros sistemas (Gu et al., 2009). Combinando vários métodos para ativar o irrigante após a sua distribuição no canal radicular utilizando o método da seringa e agulha, foi possível criar uma variedade de técnicas de irrigação. Com esta revisão pretende-se abordar e comparar os diversos métodos e técnicas de irrigação no tratamento endodôntico.
Irrigation in endodontic treatment plays a fundamental role in the cleaning and disinfection of the root canal system, whose anatomy presents itself today as one of the greatest obstacles to this disinfection. Chemical cleaning and disinfection are essential steps for the elimination of infections during root canal treatment. It is in this context that the mechanical preparation of root canals emerges during endodontic treatment, aiming to provide space for irrigants to act. However, the production of smear layer and dentin debris, iatrogenic errors, weakening of the root structure, and the formation of apical fissures continue to be disadvantages of root canal instrumentation, making a technique without instrumentation the ideal method for cleaning and disinfecting the root canal system (Şen et al., 1995; Gorni & Gagliani, 2004; Wu et al., 2000; Shemesh et al., 2006). The objectives of root canal system irrigation are the dissolution and removal of pulp tissue, dentin debris, smear layer, microorganisms, and their derivatives from the root canal walls, ensuring their elimination from the root canal system. There are currently various methods and irrigation systems that aim to achieve these objectives and overcome the obstacles of both the anatomy of the root canal system and its bacterial contamination. Currently, traditional irrigation with needle and syringe remains the most commonly used in clinical practice and during endodontic treatment (Dutner et al., 2012; Savani et al., 2014;). However, the search for improved safety and efficacy of irrigation has led to the development of other systems (Gu et al., 2009). By combining various methods to activate the irrigant after its distribution in the root canal using the syringe and needle method, it was possible to create a variety of irrigation techniques. With this review, the aim is to address and compare the various methods and techniques of irrigation in endodontic treatment.
Irrigation in endodontic treatment plays a fundamental role in the cleaning and disinfection of the root canal system, whose anatomy presents itself today as one of the greatest obstacles to this disinfection. Chemical cleaning and disinfection are essential steps for the elimination of infections during root canal treatment. It is in this context that the mechanical preparation of root canals emerges during endodontic treatment, aiming to provide space for irrigants to act. However, the production of smear layer and dentin debris, iatrogenic errors, weakening of the root structure, and the formation of apical fissures continue to be disadvantages of root canal instrumentation, making a technique without instrumentation the ideal method for cleaning and disinfecting the root canal system (Şen et al., 1995; Gorni & Gagliani, 2004; Wu et al., 2000; Shemesh et al., 2006). The objectives of root canal system irrigation are the dissolution and removal of pulp tissue, dentin debris, smear layer, microorganisms, and their derivatives from the root canal walls, ensuring their elimination from the root canal system. There are currently various methods and irrigation systems that aim to achieve these objectives and overcome the obstacles of both the anatomy of the root canal system and its bacterial contamination. Currently, traditional irrigation with needle and syringe remains the most commonly used in clinical practice and during endodontic treatment (Dutner et al., 2012; Savani et al., 2014;). However, the search for improved safety and efficacy of irrigation has led to the development of other systems (Gu et al., 2009). By combining various methods to activate the irrigant after its distribution in the root canal using the syringe and needle method, it was possible to create a variety of irrigation techniques. With this review, the aim is to address and compare the various methods and techniques of irrigation in endodontic treatment.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Irrigação endodôntica Tratamento endodôntico Técnicas de irrigação Soluções irrigantes