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Abstract(s)
Introdução: Os pacientes que necessitam de reabilitação protética fixa têm vindo a aumentar ao longo das últimas décadas. A redução dentária obrigatória dos dentes pilares embora conservativa em relação à vitalidade pulpar, não é isenta de dano. Porque nem sempre é possível garantir uma quantidade de remanescente dentinário de segurança após a sua redução e dada a sua importância por condicionar o resultado final, há necessidade de se aprofundar mais este assunto para o seu correto esclarecimento.
Objectivo: Quantificar o remanescente dentinário e espessuras de redução efetuadas na preparação de dentes pilares de prótese fixa. Estabelecer os seus relacionamentos com os indicadores de sucesso clínico: satisfação estética e complicações.
Materiais e Métodos: Estudo retrospetivo, exploratório e descritivo das distâncias mesio-distal e vestíbulo-palatino/lingual ao nível do colo e da coroa dentária dos dentes pilares recolhida nos modelos de gesso e ortopantomografias dos pacientes tratados na clínica universitária da Universidade Católica Portuguesa. Registaram-se as datas da cimentação definitiva e da última consulta de controlo, a presença de vitalidade dentária, a existência de complicações pulpares, o grau de satisfação, a estética, o sexo e a idade. O tratamento estatístico dos dados consistiu na análise univariada, bivariada usando o programa SPSS. O nível de significância usado foi de 95%.
Resultados: A médias das reduções mesio-distal ao nível do colo foi de 1,9 mm e na coroa foi de 2mm. Na zona vestíbulo-palatina/lingual a média de reduções foi de 2mm nas zonas do colo e coroa. A quantidade de redução na zona da coroa estava estatisticamente relacionada em relação à satisfação estética, p<0,05. O valor médio de remanescente dentinário da amostra avaliada foi de 1,9 mm. A dimensão da polpa é influenciada pela quantidade de remanescente dentinário, p<0,05. Houve significativamente mais paciente satisfeitos quanto à estética quando os dentes estavam vitais, p<0,05. Não foi obtido resultado estatístico significativo da quantidade de remanescente dentinário em relação ao sexo.
Conclusões: Não se encontraram complicações pulpares nas reduções efetuadas nos dentes pilares de prótese fixa. A satisfação estética estava relacionada com a maior redução vestíbulo-lingual. A espessura do remanescente dentinário estava dentro do sugerido pela literatura, estava inversamente correlacionado com a dimensão da câmara pulpar mas não com a estética. Os pacientes com próteses fixas em dentes vitais estão significativamente mais satisfeitos com a sua estética.
Introduction: Patients who require fixed prosthetic rehabilitation have been increase over the past decades. The dental reduction is not free of damage, although the conservative relationship to the pulp. It is not possible guarantee an amount of remaining dentin safety after their reduction and the final result are dependent on this term; so it is necessary clarify this subject. Objective: Quantify the remaining dentin and the dentin thickness reduction in the abutment teeth. Establish their relationships with clinical success like aesthetic satisfaction and complications. Materials and Methods: Retrospective, exploratory and descriptive study of mesial distal and bucco-palatal/lingual distances at crown and at cervical level of the abutment teeth collected in plaster models and panoramic radiographs of patients treated at the Clinic of Catholic University. We recorded permanent cementation date and the last control visit, presence of tooth vitality, existence of pulp complications, aesthetic satisfaction, gender and age. Statistical tests consisted of univariate and bivariate analysis using SPSS. The level of significance used was 95%. Results: The average of mesio-distal reductions in cervical level was 1.9 mm and in the crown was 2mm. In the bucco-palatal/lingual distance the average reduction was 2mm in cervical and crown areas. The reduction in the crown was statistically related with aesthetic satisfaction, p <0.05. The mean value for remaining dentin was 1.9 mm. The size of the pulp is influenced by the amount of remaining dentin, p <0.05. There were significantly more patients satisfied when the teeth were vital, p <0.05. There were no statistically significant results on the amount of remaining dentin about sex. Conclusion: Reductions made in abutment teeth did not cause any pulpal complication. The aesthetic satisfaction was related to greater bucco-lingual reduction. The thickness of the remaining dentin is according to the literature, it was inversely correlated with the dimension of the pulp chamber but not correlated with aesthetic. Patients with fixed prostheses on vital teeth are significantly more satisfied with their aesthetics.
Introduction: Patients who require fixed prosthetic rehabilitation have been increase over the past decades. The dental reduction is not free of damage, although the conservative relationship to the pulp. It is not possible guarantee an amount of remaining dentin safety after their reduction and the final result are dependent on this term; so it is necessary clarify this subject. Objective: Quantify the remaining dentin and the dentin thickness reduction in the abutment teeth. Establish their relationships with clinical success like aesthetic satisfaction and complications. Materials and Methods: Retrospective, exploratory and descriptive study of mesial distal and bucco-palatal/lingual distances at crown and at cervical level of the abutment teeth collected in plaster models and panoramic radiographs of patients treated at the Clinic of Catholic University. We recorded permanent cementation date and the last control visit, presence of tooth vitality, existence of pulp complications, aesthetic satisfaction, gender and age. Statistical tests consisted of univariate and bivariate analysis using SPSS. The level of significance used was 95%. Results: The average of mesio-distal reductions in cervical level was 1.9 mm and in the crown was 2mm. In the bucco-palatal/lingual distance the average reduction was 2mm in cervical and crown areas. The reduction in the crown was statistically related with aesthetic satisfaction, p <0.05. The mean value for remaining dentin was 1.9 mm. The size of the pulp is influenced by the amount of remaining dentin, p <0.05. There were significantly more patients satisfied when the teeth were vital, p <0.05. There were no statistically significant results on the amount of remaining dentin about sex. Conclusion: Reductions made in abutment teeth did not cause any pulpal complication. The aesthetic satisfaction was related to greater bucco-lingual reduction. The thickness of the remaining dentin is according to the literature, it was inversely correlated with the dimension of the pulp chamber but not correlated with aesthetic. Patients with fixed prostheses on vital teeth are significantly more satisfied with their aesthetics.
Description
Keywords
Dentina terciária Prótese parcial fixa Preparação dentária Redução Remanescente dentinário Coto dentário Tertiary dentin Partial fixed prosthodontics Dental reduction Reduction Remaining dentin Prepared tooth