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Previous issue date: 2018-11-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The great majority of the roots present curvatures and the knowledge of these curves allows the clinician a better choice for endodontic therapy. Therefore, it is necessary to use methods that can measure these curvatures with good accuracy levels. The preparation of a glide path prior to root canal instrumentation is widely suggested because can avoid possible operative errors, such as loss of centralization and apical transportation, especially in curved root canals. There is no consensus concerning the methods that can be used to measure radicular curvatures, nor regarding the efficacy of glide path. The present investigation has the objective of performing two systematic reviews in order to answer the following questions: 1- What are the methods, described in the literature, used to measure the angles and other characteristics of the curvatures of the root canals? 2- The glide path is able to reduce the apical transportation and the loss of centralization of the endodontic preparation?
Also, how does the glide path - manual or engine-driven - result in minor operative errors? Methods: Using the appropriate terms for each review, electronic searches were performed on six databases: PubMed, PubMed Central (PMC), Embase, Scopus, EBSCO Dentistry & Oral Sciences Source (DOSS) and Virtual Health Library (VHL). We used studies published in English or in any language with Latin alphabet. There was no time limit for publications. In addition, in the second review, the included studies, the risk of biases was analyzed. Results: In review 1, about the methods of measurement of curvatures, 6,336 studies were obtained and of these, 31 articles that described innovative methods. Eleven studies described the methods used to measure only the angle of the radicular curvatures, for which they used 2D images. 13 studies also used 2D images, however, in addition to the angles, evaluated other features of the root canal curvatures (position, length, direction, height and shape). In addition, seven studies evaluated curvatures using 3D methods. In review 2, regarding glide path, 2,146 articles were obtained, and 18 studies fulfilled the inclusion criteria, composing the final analysis. 9 studies evaluated the glide path per se and 11 evaluated the impact of
glide path on final engine-driven endodontic preparation. Conclusion: Revision 1
suggested that most methods for root canal curvature measurement have potential
clinical applications; however, there is a lack of consensus on the ideal technique. In
addition to the angle, other features, such as radius and position of curvature, need to
be measured and should be considered when evaluating root canal curvature in both
clinical and research purposes. Revision 2 revealed that engine-driven confection of
glide path, when compared to manual, presents similar or better results of apical
transportation and maintenance of root canal centralization. It was also observed that
the preparation of glide path, prior to endodontic preparation, is associated with similar
results or with a reduction of the apical transportation and the maintenance of the
preparation centralization. It was also observed that deviations occur in all situations. / A grande maioria dos condutos apresenta curvaturas e o conhecimento destas curvaturas permite ao cl?nico uma melhor escolha da terap?utica endod?ntica. Para tanto, faz-se necess?rio o emprego de m?todos que possam medir essas curvaturas com bons n?veis de acur?cia. A confec??o de um glide path pr?vio ? instrumenta??o dos canais radiculares ? amplamente sugerida, pois pode evitar poss?veis erros operat?rios,
tais como a perda de centraliza??o do preparo e o transporte apical, especialmente em canais radiculares curvos. Como n?o h? consenso quanto aos m?todos que podem ser utilizados na medi??o das curvaturas radiculares, tampouco referente a efic?cia do glide path, a presente investiga??o tem o objetivo de realizar duas revis?es sistem?ticas, a fim de responder ?s seguintes quest?es: 1- Quais s?o os m?todos, descritos na literatura, empregados na mensura??o dos ?ngulos e demais caracter?sticas das curvaturas dos canais radiculares? 2- O glide path ? capaz de reduzir o transporte apical e a perda de centraliza??o do preparo endod?ntico? Al?m disso, qual a forma de confec??o do glide path ? manual ou motorizada ? resulta em menores erros operat?rios?
M?todos: Utilizando os termos apropriados para cada revis?o, foram realizadas buscas eletr?nicas em seis bases de dados: PubMed, PubMed Central (PMC), Embase, Scopus, EBSCO Dentistry & Oral Sciences Source (DOSS) e Virtual Health Library (VHL). Foram utilizados estudos publicados em ingl?s ou em qualquer idioma com alfabeto latino n?o houve qualquer limite temporal para as publica??es. Al?m disso, na segunda revis?o, os estudos inclu?dos tiveram o risco de vieses analisado. Resultados: Na revis?o 1, acerca dos m?todos de mensura??o das curvaturas, foram obtidos 6.346 estudos e destes, restaram 31 artigos que descreviam m?todos inovadores. Onze estudos foram descritos a fim de mensurar apenas o ?ngulo das curvaturas radiculares, para isso utilizaram 9 imagens em 2D. 13 estudos utilizaram tamb?m imagens em 2D, entretanto, al?m dos ?ngulos avaliaram outras caracter?sticas das curvaturas dos canais radiculares (posi??o,
comprimento, dire??o, altura e forma). Al?m disso, sete estudos avaliaram as curvaturas atrav?s de m?todos em 3D. J? na revis?o 2, a respeito do glide path, obteve-se 2.146 artigos, sendo que 18 estudos preencheram os crit?rios de inclus?o, compondo a an?lise final. 9 pesquisas avaliaram a confec??o do glide path per se e 11 avaliaram a repercuss?o do glide path no preparo endod?ntico motorizado final. Conclus?o: a revis?o 1 sugeriu que a maioria dos m?todos de mensura??o de curvaturas dos canais radiculares tem potenciais aplica??es cl?nicas, no entanto, h? uma falta de consenso sobre a t?cnica ideal. Al?m do ?ngulo, outros fatores, como raio e posi??o da curvatura, precisam ser mensurados e devem ser levados em considera??o ao se avaliar a curvatura do canal radicular tanto em tratamentos cl?nicos como em ambientes de pesquisa. J? a
revis?o 2 revelou que a confec??o motorizada, quando comparada com a confec??o manual, do glide path apresenta resultados similares ou melhores de transporte apical e manuten??o da centraliza??o do canal radicular. Observou-se, tamb?m, que a confec??o do glide path, previamente ao preparo endod?ntico, est? associada com resultados similares ou com a redu??o do transporte apical e a manuten??o da centraliza??o do preparo. Tamb?m foi observado que ocorrem desvios em todas as situa??es.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8381 |
| Date | 12 November 2018 |
| Creators | Hartmann, Rafael Chies |
| Contributors | Gomes, Maximiliano Sch?nke, Rossi-Fedele, Giampiero, Figueiredo, Jos? Ant?nio Poli de |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, Brasil, Escola de Ci?ncias da Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -7411869720500764667, 500, 500, 600, -2070498469879244349, 3590462550136975366 |
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