| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 884.9 KB | Adobe PDF |
Authors
Abstract(s)
Introdução: A cárie dentária é uma doença multifatorial, que pode ser definida como uma
disbiose, biofilme e açúcar dependente, não transmissível, que resulta na perda de minerais
dos tecidos duros dentários. Em situações de lesões cariosas profundas, sem
sintomatologia de patologia pulpar, os dentes devem ser tratados na tentativa de preservar
a sua vitalidade. Existem formas diferentes de remover o tecido cariado, sendo que a
remoção total ou seletiva, podem ser indicadas.
Objetivo: Através de uma revisão sistemática, o objetivo foi clarificar o nível de evidencia
científica, relacionado a opções de tratamento para lesões de cárie profunda em dentes
permanentes, e direcionar o clínico, na decisão da técnica de tratamento.
Materiais e métodos: A literatura considerada para esta revisão sistemática é baseada
nas diretrizes PRISMA e visou responder a seguinte questão específica construída no
formato PICO: “Em dentes permanentes com lesões profundas (P), qual seria o melhor
tratamento para um sucesso clínico (O) remoção seletiva de tecido cariado (I) ou total (C)?”
Foi realizada uma pesquisa eletrónica nas bases de dados Pubmed, Web Of Science a fim
de identificar estudos clínicos que comparassem a remoção total com a remoção seletiva,
em um período de acompanhamento mínimo de seis meses. Após estabelecer a estratégia
de pesquisa, os estudos foram selecionados, através da ferramenta Rayyan’s Intelligent
Systematic Review Plattaform, com os critérios de inclusão e exclusão. Os dados foram
extraídos por dois revisores independentes e quaisquer divergências eram discutidas com
um terceiro revisor. A qualidade metodológica foi analisada através da ferramenta Rob2.
Os dados obtidos puderam ser agrupados e comparados, e por isso, procedeu-se a metanálise. A variável primária utilizada foi a longevidade do tratamento frente ao tipo de
remoção de tecido cariado.
Resultados: 105 artigos foram identificados no decorrer da pesquisa. Após a exclusão dos
duplicados, 95 estudos foram avaliados tendo em conta o título e o abstract, onde 20
acabaram por ser selecionados para a leitura integral com a finalidade de avaliar a sua
elegibilidade. Um total de 5 estudos foram incluídos para análise desta revisão sistemática.
Conclusão: A remoção seletiva de tecido cariado para ser mais favorável para longevidade
do tratamento em até 1 ano 6 meses. Entretanto aos 5 anos de acompanhamento não há
diferença entre remoção seletiva e remoção total na longevidade do tratamento. Portanto,
optar pela remoção seletiva evita a exposição pulpar, o que é um benefício. Não há
conclusões se a remoção seletiva tem maior sucesso sendo feita em uma ou mais sessões.
Introduction: Dental caries is a multifactorial disease, which can be defined as a nontransmissible, biofilm and sugar-dependent dysbiosis that results in the loss of minerals from dental hard tissues. In situations of deep carious lesions, without symptoms of pulpal pathology, teeth should be treated in an attempt to preserve their vitality. There are different ways to remove carious tissue, and total or selective removal may be indicated. Objective: Through a systematic review of clinical studies, the level of scientific evidence related to treatment options for deep caries lesions in permanent teeth was sought to guide the clinician in deciding the treatment technique. Materials and methods: The literature considered for this systematic review is based on PRISMA guidelines and aimed to answer the following specific question constructed in PICO format: "In permanent teeth with deep lesions (P), which would be the best treatment for a clinical success (O) selective removal of carious tissue (I) or total (C)?" An electronic search was conducted in Pubmed, Web Of Science databases in order to identify clinical studies comparing total removal versus selective removal in a minimum follow-up period of six months. After establishing the search strategy, the studies were selected, with the inclusion and exclusion criteria, the extracted data was completed by two independent reviewers and any disagreements between the reviewers were discussed with a third reviewer. Study selection was confirmed using Rayyan's Intelligent Systematic Review Plattaform tool and methodological quality using the Rob2 tool. Data obtained from the included studies were extracted and analysed using a continuous random effects model meta-analysis. The primary variable used was treatment longevity versus the type of decayed tissue removal. Results: 105 articles were identified during the search. After the exclusion of duplicates, 95 studies were assessed taking into account the title and the abstract, where 20 were eventually selected for full reading with the purpose of assessing their eligibility. A total of 5 studies were included for analysis in this systematic review. Conclusion: Selective removal of decayed tissue was found to be more favourable for treatment longevity up to 1 year 6 months. However, at 5 years follow-up there is no difference between selective removal and total removal in treatment longevity. Therefore, choosing selective removal avoids pulpal exposure, which is a benefit. There is no conclusion whether selective removal is more successful when done in one or more sessions.
Introduction: Dental caries is a multifactorial disease, which can be defined as a nontransmissible, biofilm and sugar-dependent dysbiosis that results in the loss of minerals from dental hard tissues. In situations of deep carious lesions, without symptoms of pulpal pathology, teeth should be treated in an attempt to preserve their vitality. There are different ways to remove carious tissue, and total or selective removal may be indicated. Objective: Through a systematic review of clinical studies, the level of scientific evidence related to treatment options for deep caries lesions in permanent teeth was sought to guide the clinician in deciding the treatment technique. Materials and methods: The literature considered for this systematic review is based on PRISMA guidelines and aimed to answer the following specific question constructed in PICO format: "In permanent teeth with deep lesions (P), which would be the best treatment for a clinical success (O) selective removal of carious tissue (I) or total (C)?" An electronic search was conducted in Pubmed, Web Of Science databases in order to identify clinical studies comparing total removal versus selective removal in a minimum follow-up period of six months. After establishing the search strategy, the studies were selected, with the inclusion and exclusion criteria, the extracted data was completed by two independent reviewers and any disagreements between the reviewers were discussed with a third reviewer. Study selection was confirmed using Rayyan's Intelligent Systematic Review Plattaform tool and methodological quality using the Rob2 tool. Data obtained from the included studies were extracted and analysed using a continuous random effects model meta-analysis. The primary variable used was treatment longevity versus the type of decayed tissue removal. Results: 105 articles were identified during the search. After the exclusion of duplicates, 95 studies were assessed taking into account the title and the abstract, where 20 were eventually selected for full reading with the purpose of assessing their eligibility. A total of 5 studies were included for analysis in this systematic review. Conclusion: Selective removal of decayed tissue was found to be more favourable for treatment longevity up to 1 year 6 months. However, at 5 years follow-up there is no difference between selective removal and total removal in treatment longevity. Therefore, choosing selective removal avoids pulpal exposure, which is a benefit. There is no conclusion whether selective removal is more successful when done in one or more sessions.
Description
Keywords
Remoção seletiva Remoção total Lesão de cárie profunda Restauração dentária Exposição pulpar Selective removal Total removal Deep caries lesion Dental restoration Pulpal exposure