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Evolução da composição das ligas metálicas utilizadas em endodontia mecanizada : da liga de aço inoxidável à liga M-Wire
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Abstract(s)
Até ao fim da década de 80, a preparação biomecânica do tratamento endodôntico era apenas realizada pelo recurso a brocas e limas de aço inoxidável manuais, verificando-se recorrentemente desvios, perfurações e a fratura dos instrumentos. Com o objetivo de diminuir o risco de preparações defeituosas, a liga de Níquel-Titânio (NiTi) promoveu a introdução de instrumentos endodônticos, com modificações aos níveis do design, tratamento superficial e térmico, possibilitando o acoplamento de limas endodônticas a um motor elétrico. Embora a realização de movimentos rotatórios contínuos com limas de NiTi acionadas por motores elétricos tivessem tornado possível obter maior agilidade, conforto e conformação dos canais radiculares, verificou-se um aumento nas taxas de fratura durante a preparação. Por forma a proporcionar maior segurança e eficiência durante a preparação clínica, otimizando as propriedades mecânicas dos instrumentos e do seu efeito, têm vindo a ser incorporados novos movimentos aquando da instrumentação dos canais radiculares. O objetivo deste trabalho consiste na revisão da literatura sobre a evolução das ligas metálicas utilizadas no fabrico das diversas gerações de limas empregues na instrumentação endodôntica mecanizada, desde a liga de aço inoxidável até à liga de Níquel-Titânio e a sua importância para a evolução da endodontia. A pesquisa bibliográfica realizou-se nas bases de dados PubMed, The Cochrane Library, Wiley Online Library, Elsevier e Scielo, tendo os artigos sido selecionados com base na sua relevância e privilegiados os estudos com menos de dez anos. Os resultados dos estudos demonstram que a evolução das ligas metálicas utilizadas na instrumentação endodôntica mecanizada representou um enorme avanço para a endodontia, promovendo melhorias na qualidade e previsibilidade da preparação dos canais radiculares, bem como uma significativa redução dos erros processuais e do tempo de consulta, diminuindo o desconforto por parte do paciente e do médico dentista.
Until the end of the 80s, the biomechanical preparation of endodontic treatment was only performed using hand drills and stainless-steel files, with recurrent deviations, perforations and fracture of the instruments. In order to reduce the risk of defective preparations, the nickel-titanium (NiTi) alloy introduced new endodontic instruments, with modifications in design, surface and heat treatment, allowing the coupling of files to an electric motor. Although the continuous rotary motion with electric motor NiTi files made possible to obtain greater agility, confort and conformation of the root canals, there was an increase in fracture rates during preparation. In order to provide greater safety and efficiency during clinical preparation, optimizing the mechanical properties of the instruments and their effect, new movements have been incorporated during root canal instrumentation. The objective of this literature review is to discuss the changes in the metallic alloys used in the manufacture of several generations of files used in mechanized endodontic instrumentation, from stainless steel alloy to nickel titanium alloy and their importance for evolution of endodontics. The bibliographic search was carried out in the databases PubMed, The Cochrane Library, Wiley Online Library, Elsevier and Scielo, having the articles been selected based on their relevance, privileging the studies under ten years. The results of the studies show that the evolution of metallic alloys used in mechanized endodontic instrumentation represented an huge advance for endodontics, promoting improvements in the quality and predictability of root canal preparation, as well as a significant reduction in procedural errors and consultation time, reducing discomfort on the part of the patient and the dentist.
Until the end of the 80s, the biomechanical preparation of endodontic treatment was only performed using hand drills and stainless-steel files, with recurrent deviations, perforations and fracture of the instruments. In order to reduce the risk of defective preparations, the nickel-titanium (NiTi) alloy introduced new endodontic instruments, with modifications in design, surface and heat treatment, allowing the coupling of files to an electric motor. Although the continuous rotary motion with electric motor NiTi files made possible to obtain greater agility, confort and conformation of the root canals, there was an increase in fracture rates during preparation. In order to provide greater safety and efficiency during clinical preparation, optimizing the mechanical properties of the instruments and their effect, new movements have been incorporated during root canal instrumentation. The objective of this literature review is to discuss the changes in the metallic alloys used in the manufacture of several generations of files used in mechanized endodontic instrumentation, from stainless steel alloy to nickel titanium alloy and their importance for evolution of endodontics. The bibliographic search was carried out in the databases PubMed, The Cochrane Library, Wiley Online Library, Elsevier and Scielo, having the articles been selected based on their relevance, privileging the studies under ten years. The results of the studies show that the evolution of metallic alloys used in mechanized endodontic instrumentation represented an huge advance for endodontics, promoting improvements in the quality and predictability of root canal preparation, as well as a significant reduction in procedural errors and consultation time, reducing discomfort on the part of the patient and the dentist.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Limas endodônticas Tratamento endodôntico Liga de Níquel-Titânio Fadiga cíclica