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Abstract(s)
Apesar de todos os esforços implementados no sentido de aperfeiçoar os tratamentos endodônticos e desenvolver novas técnicas, o insucesso é expectável em cerca de 23% dos casos.
Strindberg considera fracasso os tratamentos de dentes com rarefacções ósseas periapicais que aumentam, permanecem inalteradas, apenas diminuem de tamanho ou aparecem após o tratamento endodôntico.
Estes casos devem-se à falha do tratamento endodôntico inicial, tornando-se necessário corrigir procedimentos defeituosos ou erradicar microrganismos persistentes. No entanto, verifica-se, entre profissionais ,uma grande variabilidade de opiniões quanto à realização do retratamento e das técnicas de obturação a usar.
O insucesso endodôntico tem uma etiologia multifactorial, sendo que as causas da falência da terapêutica podem dividir-se em infiltração apical, erros operatórios e erros na seleção de casos. Geralmente, a maior causa de insucesso é a sobrevivência de microrganismos na porção apical do dente, especialmente o Enterococcus faecalis, que apresenta resistência ao hidróxido de cálcio.
Cada caso clínico deve ser avaliado de maneira individual e o plano de tratamento deve ser adequado à causa do insucesso de cada um e a variados factores pré operatórios que ditarão o tipo e a exequibilidade do retratamento endodôntico.
Variadas técnicas foram desenvolvidas para a desobturação canalar, estando a sua utilização a cargo da preferência e subjectividade de cada operador.
Com a realização da presente monografia, pretendeu-se estabelecer um paralelismo entre a literatura e a parte clínica e acompanhar a evolução clínica de cada caso, obtendo conclusões dos mesmos
Despite all the efforts implemented to improve endodontic treatments and develop new techniques, failure is expected in about 23% of cases. Strindberg considers failures as treatments of teeth with periapical bony rarefactions that increase, remain unchanged, decrease in size or only appear after endodontic treatment. These cases are due to the failure of inicial endodontic treatment, making it necessary to correctfaulty procedures or eradicate persistent organisms. Howevwe, there is, mong professionals, a broad range of opinions regarding the realization of retreatment and obturation techniques to use. Endodontic failure has a multifactorial etiology and the causes of treatment failure can be divided into apical leakage, surgical errors and errors in the selection of cases. Generally, the major cause of failure is the survival of microorganisms in the apical portion of the tooth, particularly Enterococcus faecalis, which is resistant to calcium hydroxide. Each clinical case must be assessed individually and treatment plan should be appropriate to the cause of failure of each one and to a variety of pre operative factors that will dictate the type and feasibility of endodontic retreatment. Various techniques have been developed for the root canal desobturation procedure, and its use is dependent on preference and subjectivity of each operator. The completion of this monograph was indeed to draw a parallel between literature and clinical side and follow the clinical course of each case, obtaining conclusions of each one.
Despite all the efforts implemented to improve endodontic treatments and develop new techniques, failure is expected in about 23% of cases. Strindberg considers failures as treatments of teeth with periapical bony rarefactions that increase, remain unchanged, decrease in size or only appear after endodontic treatment. These cases are due to the failure of inicial endodontic treatment, making it necessary to correctfaulty procedures or eradicate persistent organisms. Howevwe, there is, mong professionals, a broad range of opinions regarding the realization of retreatment and obturation techniques to use. Endodontic failure has a multifactorial etiology and the causes of treatment failure can be divided into apical leakage, surgical errors and errors in the selection of cases. Generally, the major cause of failure is the survival of microorganisms in the apical portion of the tooth, particularly Enterococcus faecalis, which is resistant to calcium hydroxide. Each clinical case must be assessed individually and treatment plan should be appropriate to the cause of failure of each one and to a variety of pre operative factors that will dictate the type and feasibility of endodontic retreatment. Various techniques have been developed for the root canal desobturation procedure, and its use is dependent on preference and subjectivity of each operator. The completion of this monograph was indeed to draw a parallel between literature and clinical side and follow the clinical course of each case, obtaining conclusions of each one.
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Keywords
Insucesso endodôntico Retratamento Etiologia Técnicas de retratamento Microbiologia do retratamento Endodontic failure Endodontic retreatment Etiology Retreatment techniques Retreatment microbiology