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Sobrevivência de dentes restaurados sem poste com tratamento endodôntico numa clínica dentária
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Abstract(s)
Objetivos: Pretende-se, com esta investigação avaliar a taxa de sobrevivência de dentes
restaurados com tratamento endodôntico, através da história clínica e respetiva análise
radiográfica, e fazer a comparação com dentes restaurados com poste de fibra.
Material e métodos: Na elaboração desta investigação foram incluídos 17 processos de
pacientes, nos quais foram estudados 27 dentes com tratamento endodôntico. Foram excluídos pacientes com dentes restaurados em amálgama e ionómero de vidro, restaurações na face oclusal / bordo inicial e selamento apical com mais de 2 mm. Foram recolhidos dados correspondentes ao sexo, idade, número do dente tratado, data do tratamento endodôntico, data da restauração, presença ou ausência do dente na arcada, t ipo de reabilitação (ocluso-mesial; ocluso-distal; ocluso-mesio-distal) e presença ou ausência de imagem radiotransparente a nível periapical.
Resultados: Os dentes receberam tratamento endodôntico no período entre 2010 e 2015.
A última consulta de controlo foi realizada em 2019. A amostra deste estudo continha 27
dentes (33% do sexo masculino e 67% do sexo feminino). Destes, 14 (52%) apresentavam-se na maxila e 13 (48%) na mandíbula; 5 (19%) no setor anterior e 22 (81%) no setor posterior. 37% da amostra apresentava lesão apical inicial e 7% lesão apical na última consulta de controlo. Para o primeiro objetivo, os resultados demonstram uma taxa de sobrevivência de 100% até um período de 60 meses e uma taxa de sucesso de 93%. Para o segundo objetivo, obteve-se uma taxa de sobrevivência de dentes endodonciados sem poste diferente à taxa de sobrevivência de dentes endodonciados com poste. No teste Binomial, para um teste de proporção de 100% para um período de 60 meses, os dentes sem poste exibiram um p-value igual a 0,973 enquanto que os dentes com poste mostraram um valor igual a 1,24 × 10-8. No primeiro caso, aceitou-se a hipótese nula (i.e. a restauração de um dente endodonciado sem poste tem uma taxa de sobrevivência de 100% até um período de 60 meses) e, no segundo caso, rejeitou-se a hipótese nula e aceitou-se a alternativa (i.e. a restauração de um dente endodonciado com poste não tem uma taxa de sobrevivência de 100% até um período de 60 meses).
Conclusão: Através dos resultados, foi demonstrada uma elevada taxa de sobrevivência
dos dentes restaurados sem poste com tratamento endodôntico equivalente a 100% até um período de 60 meses. Em comparação com as restaurações com poste de fibra, dos resultados obtidos através de uma tese com metodologia semelhante, verificou-se que a sobrevivência é diferente. Concluiu-se que a taxa de sobrevivência dos dentes restaurados sem poste com tratamento endodôntico é maior. Contudo, é necessária cautela na avaliação dos dentes com indicação para utilização dos postes, devendo ter muita atenção aos fatores que condicionam a tomada de decisão da sua utilização, de modo a proporcionar a melhor reabilitação oral ao doente.
Objectives: This non-interventional investigation aims to evaluate the survival rate of teeth with endodontic treatment, through their clinical history and respective radiographic analysis, and to compare the survival rate of teeth subjected to endodontic treatment without posts (analysed in this study) with teeth restored with fiber posts. Materials and methods: Throughout this investigation, 17 patient processes were included, in which 27 teeth previously submitted to endodontic treatment were studied. Patients with restored teeth using amalgam and glass ionomer, restorations on the occlusal surface / initial border and apical sealing with more than 2 mm were excluded. Data were collected corresponding to sex, age, number of teeth treated, date of endodontic treatment, date of restoration, presence or absence of the tooth in the arch, type of re-biliary (occlusal and mesial; occlusal and distal; mesial, occlusal and distal) and the presence or absence of a radiolucent image at the periapical level. Results: All teeth received endodontic treatment in the period from 2010 to 2015. The last control visit was performed in 2019. The study’s sample comprised 27 teeth (33% male and 67% female). Out of these, 14 (52%) were present in the maxilla and 13 (48%) in the mandible; 5 (19%) in the anterior sector and 22 (81%) in the posterior sector. 37% of the sample had initial apical lesion and 7% showed apical lesion at the last control visit. Concerning the first objective, the results demonstrate a survival rate of 100% over a period of 60 months, and a rate success rate of 93%. For the second objective, it was established that there is a statistically significant difference between the survival rate of endodontically treated teeth without post and that of endodontically treated teeth with posts. By means of a Binomial statistical test, for a test proportion of 100% in a period of 60 months, teeth with posts exhibited a p-value equal to 0.973, whereas teeth with posts showed a value equal to 1.24 × 10-8. In the first case, the null hypothesis was accepted (i.e. the restauration of a tooth without a post has a survival rate of 100% within a period of 60 months) and, in the second case, the null hypothesis was rejected and the alternative accepted (i.e. the restauration of a tooth with a post does not have a survival rate of 100% within a period of 60 months). Conclusion: A high survival rate of restored teeth without post with endodontic treatment equivalent to 100% was demonstrated over a period of 60 months. In comparison with fibre post-containing restorations, it is likely that there is an overall difference in the survival rate after having compared the results of this study that those obtained in a thesis with similar methodology. It was concluded that the survival rate of the endodontically treated teeth without posts is probably higher. However, caution is required in the evaluation of teeth indicating the necessity of post use. Furthermore, close attention is warranted concerning the factors that influence the decision making of their use, in order to provide the best oral rehabilitation to the patient.
Objectives: This non-interventional investigation aims to evaluate the survival rate of teeth with endodontic treatment, through their clinical history and respective radiographic analysis, and to compare the survival rate of teeth subjected to endodontic treatment without posts (analysed in this study) with teeth restored with fiber posts. Materials and methods: Throughout this investigation, 17 patient processes were included, in which 27 teeth previously submitted to endodontic treatment were studied. Patients with restored teeth using amalgam and glass ionomer, restorations on the occlusal surface / initial border and apical sealing with more than 2 mm were excluded. Data were collected corresponding to sex, age, number of teeth treated, date of endodontic treatment, date of restoration, presence or absence of the tooth in the arch, type of re-biliary (occlusal and mesial; occlusal and distal; mesial, occlusal and distal) and the presence or absence of a radiolucent image at the periapical level. Results: All teeth received endodontic treatment in the period from 2010 to 2015. The last control visit was performed in 2019. The study’s sample comprised 27 teeth (33% male and 67% female). Out of these, 14 (52%) were present in the maxilla and 13 (48%) in the mandible; 5 (19%) in the anterior sector and 22 (81%) in the posterior sector. 37% of the sample had initial apical lesion and 7% showed apical lesion at the last control visit. Concerning the first objective, the results demonstrate a survival rate of 100% over a period of 60 months, and a rate success rate of 93%. For the second objective, it was established that there is a statistically significant difference between the survival rate of endodontically treated teeth without post and that of endodontically treated teeth with posts. By means of a Binomial statistical test, for a test proportion of 100% in a period of 60 months, teeth with posts exhibited a p-value equal to 0.973, whereas teeth with posts showed a value equal to 1.24 × 10-8. In the first case, the null hypothesis was accepted (i.e. the restauration of a tooth without a post has a survival rate of 100% within a period of 60 months) and, in the second case, the null hypothesis was rejected and the alternative accepted (i.e. the restauration of a tooth with a post does not have a survival rate of 100% within a period of 60 months). Conclusion: A high survival rate of restored teeth without post with endodontic treatment equivalent to 100% was demonstrated over a period of 60 months. In comparison with fibre post-containing restorations, it is likely that there is an overall difference in the survival rate after having compared the results of this study that those obtained in a thesis with similar methodology. It was concluded that the survival rate of the endodontically treated teeth without posts is probably higher. However, caution is required in the evaluation of teeth indicating the necessity of post use. Furthermore, close attention is warranted concerning the factors that influence the decision making of their use, in order to provide the best oral rehabilitation to the patient.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Tratamento endodôntico Sobrevivência Sucesso Poste de fibra Restauração