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Em que casos podia estar indicado a utilização da endodontia guiada?
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Advisor(s)
Abstract(s)
A grande evolução digital que presenciamos no dia-a-dia estende-se também à medicina dentária e as tecnologias digitais podem ser aplicadas em vários campos da prática clinica. A informação digital imagiológica obtida a duas e três dimensões pode atualmente ser conjugada com um scanner intraoral que permite a criação de uma guia auxiliar à Endodontia. Com esta abordagem, pode-se considerar uma diferente resolução de casos de dificuldade mais elevada como dentes com canais calcificados e cirurgia endodôntica.
Essas duas principais aplicações são descritas nesta monografia, juntamente com suas vantagens e inconvenientes. O acesso microguiado pode ser projetado para a localização do canal radicular, enquanto uma abordagem cirúrgica endodôntica guiada pode resultar em osteotomia precisa e ressecção da raiz. Embora o nível de evidência seja baixo e a metodologia descrita entre os estudos seja heterogénea, todos os artigos descrevem a preparação da cavidade de acesso guiado e a cirurgia guiada como sendo técnicas altamente precisas e bem-sucedidas quando se compara o caminho perfurado com o tratamento planeado. Outro desafio na utilização das guias é obter uma irrigação ótima durante o procedimento. Os clínicos devem, portanto, recorrer ao uso de brocas com boa eficiência de corte e à irrigação e limpeza das brocas para minimizar a iniciação ou propagação de fissuras.
Mais estudos com um número maior de pacientes são necessários para se obter conclusões significativas.
The big digital evolution that we witness on a daily basis also extends towards dentistry and the digital tecnologies can be applied in several aeras of a dentist clinical practice. The imagiologic digital information that we can obtain in two and three dimensions can now be added with a intraoral scanner that allows the manufacturing of na auxiliary endodontic guide. With this approach, a diferent solution can be taken int account when solving cases of higher difficulty such as pulp canal calcification ans endodontic surgery. These two main applications are described in this monograph, together with their advantages and disadvantages. The microguided access can be designed to locate the root canal, while a guided endodontic surgical approach can result in precise osteotomy and root resection. Although the level of evidence is low and the methodology described among the studies is heterogeneous, all articles describe the preparation of the guided access cavity and the guided surgery as highly accurate and successful techniques when comparing the perforated path with the planned treatment. Another challenge in using the guides is to obtain optimal irrigation during the procedure. Clinicians should therefore use drills with good cutting efficiency and irrigation and cleaning of the drills to minimize crack initiation or propagation. Further studies with a larger number of patients are needed to obtain meaningful conclusions.
The big digital evolution that we witness on a daily basis also extends towards dentistry and the digital tecnologies can be applied in several aeras of a dentist clinical practice. The imagiologic digital information that we can obtain in two and three dimensions can now be added with a intraoral scanner that allows the manufacturing of na auxiliary endodontic guide. With this approach, a diferent solution can be taken int account when solving cases of higher difficulty such as pulp canal calcification ans endodontic surgery. These two main applications are described in this monograph, together with their advantages and disadvantages. The microguided access can be designed to locate the root canal, while a guided endodontic surgical approach can result in precise osteotomy and root resection. Although the level of evidence is low and the methodology described among the studies is heterogeneous, all articles describe the preparation of the guided access cavity and the guided surgery as highly accurate and successful techniques when comparing the perforated path with the planned treatment. Another challenge in using the guides is to obtain optimal irrigation during the procedure. Clinicians should therefore use drills with good cutting efficiency and irrigation and cleaning of the drills to minimize crack initiation or propagation. Further studies with a larger number of patients are needed to obtain meaningful conclusions.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
CBCT Acesso guiado Endodontia guiada Cirurgia guiada Modelo impresso 3D