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Avaliação por CBCT da preparação apical de canais radiculares utilizando diferentes técnicas de instrumentação
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Introdução: A preservação da anatomia original dos canais radiculares durante a preparação biomecânica constitui um fator determinante para o sucesso do tratamento endodôntico. O objetivo deste estudo foi comparar a capacidade de conformação apical dos sistemas ProTaper Gold e HyFlex EDM em canais radiculares simulados, através de análise por tomografia computorizada de feixe cónico (CBCT). Materiais e Métodos: Realizou-se um estudo experimental in vitro utilizando 10 réplicas em resina de molares inferiores com anatomia padronizada, divididas em dois <br/>grupos (n=5): Grupo A (sistema ProTaper Gold) e Grupo B (sistema HyFlex EDM). Após irrigação padronizada com NaOCl a 2,5%, foram obtidas imagens por CBCT (voxel size de 75 µm) pré e pós-instrumentação. Realizaram-se medições aos 4 mm e 6 mm aquém do ápice utilizando o software Romexis. Os dados foram submetidos aos testes estatísticos de Wilcoxon, Mann-Whitney e Kruskal-Wallis. Resultados/Discussão: Ambos os sistemas promoveram aumento das dimensões dos canais radiculares após a instrumentação. No grupo HyFlex EDM observaram-se alterações estatisticamente significativas em vários parâmetros dos canais mesiovestibular e mesiolingual, enquanto no grupo ProTaper Gold as diferenças <br/>significativas foram identificadas principalmente no canal distal ao nível de 6 mm do ápice. A comparação direta entre os sistemas revelou diferenças estatisticamente significativas apenas no canal distal, nomeadamente na dimensão H aos 4 mm e nas dimensões W e D aos 6 mm. Nas restantes localizações analisadas não foram encontradas diferenças significativas entre os sistemas. Conclusão: Conclui-se que ambos os sistemas foram capazes de promover a preparação biomecânica dos canais radiculares, apresentando comportamento semelhante na maioria das situações avaliadas. Contudo, o sistema ProTaper Gold demonstrou uma tendência para produzir maior alargamento no canal distal, enquanto o HyFlex EDM apresentou alterações dimensionais mais uniformes nos canais mesiais. A CBCT foi eficaz na avaliação tridimensional, <br/>sendo necessários ensaios in vivo para validação clínica.
Introduction: The preservation of the original root canal anatomy during biomechanical preparation is a determining factor for the success of <br/>endodontic treatment. The objective of this study was to compare the apical shaping ability of the ProTaper Gold and HyFlex EDM systems <br/>in simulated root canals using cone-beam computed tomography (CBCT) analysis. Methods and Materials: An in vitro experimental study was conducted using 10 resin replicas of mandibular molars with standardized anatomy divided into two groups (n=5): Group A (ProTaper Gold system) and Group B (HyFlex EDM system). Following standardized irrigation with 2.5% NaOCl, CBCT scans (75 µm voxel size) were acquired before and after instrumentation. Measurements were performed at 4 mm and 6 mm short of the apex using Romexis software. Data were subjected to <br/>Wilcoxon, Mann-Whitney, and Kruskal-Wallis statistical tests. Results/Discussion: Both systems promoted an increase in root canal dimensions after instrumentation. In the HyFlex EDM group, statistically significant changes were observed in several parameters of the mesiobuccal and mesiolingual canals, whereas in the ProTaper Gold group, significant differences were identified mainly in the distal canal at 6 mm from the apex. Direct comparison between the systems revealed statistically significant differences only in the distal canal, specifically in dimension H at 4 mm and dimensions W and D at 6 mm. No significant differences were found between the systems in the remaining analyzed locations. Conclusion: It is concluded that both systems were capable of promoting the biomechanical preparation of root canals, exhibiting similar behavior in most evaluated situations. However, the ProTaper Gold system demonstrated a tendency to produce greater enlargement in the distal canal, while the HyFlex EDM presented more uniform dimensional changes in the mesial canals. CBCT was effective for three-dimensional evaluation; however, in vivo trials are required for clinical validation.
Introduction: The preservation of the original root canal anatomy during biomechanical preparation is a determining factor for the success of <br/>endodontic treatment. The objective of this study was to compare the apical shaping ability of the ProTaper Gold and HyFlex EDM systems <br/>in simulated root canals using cone-beam computed tomography (CBCT) analysis. Methods and Materials: An in vitro experimental study was conducted using 10 resin replicas of mandibular molars with standardized anatomy divided into two groups (n=5): Group A (ProTaper Gold system) and Group B (HyFlex EDM system). Following standardized irrigation with 2.5% NaOCl, CBCT scans (75 µm voxel size) were acquired before and after instrumentation. Measurements were performed at 4 mm and 6 mm short of the apex using Romexis software. Data were subjected to <br/>Wilcoxon, Mann-Whitney, and Kruskal-Wallis statistical tests. Results/Discussion: Both systems promoted an increase in root canal dimensions after instrumentation. In the HyFlex EDM group, statistically significant changes were observed in several parameters of the mesiobuccal and mesiolingual canals, whereas in the ProTaper Gold group, significant differences were identified mainly in the distal canal at 6 mm from the apex. Direct comparison between the systems revealed statistically significant differences only in the distal canal, specifically in dimension H at 4 mm and dimensions W and D at 6 mm. No significant differences were found between the systems in the remaining analyzed locations. Conclusion: It is concluded that both systems were capable of promoting the biomechanical preparation of root canals, exhibiting similar behavior in most evaluated situations. However, the ProTaper Gold system demonstrated a tendency to produce greater enlargement in the distal canal, while the HyFlex EDM presented more uniform dimensional changes in the mesial canals. CBCT was effective for three-dimensional evaluation; however, in vivo trials are required for clinical validation.
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Preparação do canal radicular Tomografia computorizada por feixe cónico Endodontia Root canal preparation Cone-beam computed tomography Endodontics
Contexto Educativo
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Licença CC
Sem licença CC