Análise comparativa de diferentes métodos de odontometria

Abstract

Introdução: A odontometria constitui uma etapa fundamental para o sucesso do tratamento endodôntico, atualmente existem diversos métodos para a obtenção dessa medida. Objetivo: Realizar uma comparação entre o comprimento real do dente mensurado pelas técnicas de Ingle e eletrônica, utilizando os localizadores apicais eletrônicos Root ZX e Propex. Material e método: Foram selecionados 24 pacientes para participar do estudo, obtendo-se um grupo de vinte e quatro dentes unirradiculares, com rizogênese completa e diagnóstico de necrose pulpar, para realização das mensurações. Após o isolamento, acesso e neutralização do conteúdo séptico do canal radicular, todos os dentes foram submetidos às três técnicas de odontometria, obtendo-se assim o comprimento real do dente. Os dados foram submetidos a uma análise estatística descritiva. Após verificação da normalidade dos dados mediante emprego do teste de Shapiro-Wilk, realizou-se o teste ANOVA o qual demonstrou efeito significativo do tipo de método utilizado para obter os valores do comprimento real do dente. Resultados: A comparação par a par com ajuste de Bonferroni revelou que a média dos valores do comprimento real do dente obtidos por meio da técnica radiográfica de Ingle e do localizador Root ZX foram diferentes de maneira significativa da média dos valores obtidos usando o localizador Propex. Conclusão: Com base nos dados apresentados, conclui-se que o localizador apical Propex apresentou resultados diferentes dos obtidos pela técnica de Ingle e pelo localizador Root ZX.

Descritores : Odontometria; Cavidade Pulpar; Ápice Dentário.

Referências

1. Lin LM, Skribner JE, Gaengler P. Factors associated with endodontic treatment failures. J Endod. 1992;18(12):625-27.
2. Song M, Kim HC, Lee W, Kim E. Analysis of the Cause of Failure in Nonsurgical Endodontic Treatment by Microscopic Inspection during Endodontic Microsurgery. J Endod. 2011;37(11):1516-19.
3. Estrela C, Holland R, Estrela CR, Alencar AH, Sousa-Neto MB, Pécora JD. Characterization of Successful root canal treatment. Braz Dent J. 2014;25(1):3-11.
4. Nair PNR. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006;39:249-81.
5. Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod. 2005;31(4):271-74.
6. Ricucci D, Langeland K. Apical limit of root canal instrumentation and obturation, part 2: a histological study. Int Endod J. 1998;31(6):394-409.
7. Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I et al. Success rate of endodontic treatment of teeth with vital and nonvital pulps: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):95-9.
8. Kuttler Y. Microscopic investigation of root apexes. J Am Dent Assoc. 1955;50(5):544-52.
9. Dummer P, McGinn J, Rees D. The position and topography of the apical canal constriction and apical foramen. Int Endod J. 1984;17(4):192–98.
10. Heo MS, Han DH, An BM, Huh KH, Yi WJ, Lee SS et al. Effect of ambient light and bit depth of digital radiograph on observer performance in determination of endodontic file positioning. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):239-44.
11. Bramante CM, Berbert A. A critical evaluation of some methods of determining tooth length. Oral Surg Oral Med Oral Pathol. 1974;37(3):463-73.
12. Farida A, Maryam E, Ali M, Ehsan M, Sajad Y, Soraya K. A comparison between conventional and digital radiography in root canal working length determination. Indian J Dent Res. 2013;24(2):229-33.
13. Athar A, Angelopoulos C, Katz JO, Williams KB, Spencer P. Radiographic endodontic working length estimation: comparison of three digital image receptors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(4):604-8.
14. Salemi F, Saati S, Falah-Kooshki S. A comparative study of the conventional and digital intraoral radiography methods for root canal length measurement Braz Dent Sci. 2014;17(4):34-9.
15. Katz A, Tamse A, Kaufman AY. Tooth length determination: a review. Oral Surg Oral Med Oral Pathol. 1991;72(2):238–42.
16. Pratten DH, McDonald NJ. Comparison of radiographic and electronic working lengths. J Endod. 1996;22(4):173-76.
17. Tamse A, Kaffe I, Fishel D. Zygomatic arch interference with correct radiographic diagnosis in maxillary molar endodontics. Oral Surg Oral Med Oral Pathol. 1980; 50(6):563-66.
18. Cox VS, Brown CE Jr, Bricker SL, Newton CW. Radiographic interpretation of endodontic file length. Oral Surg Oral Med Oral Pathol. 1991;72(3):340-44
19. Lambrianidis T. Observer variations in radiographic evaluation of endodontic therapy. Endod Dent Traumatol. 1985;1(6):235-41.
20. Martínez-Lozano MA, Forner-Navarro L, Sánchez-Cortés JL, Llena-Puy C. Methodological considerations in the determination of working length. Int Endod J. 2001;34(5):371-76
21. Ahmad IA, Pani SC. Accuracy of eletronic Apex locator in primary teeth: a meta-analysis. Int Endod J. 2015;48(3):298-307.
22. Vieyra JP, Acosta J. Comparison of working length determination with radiographs and four electronic apex locators. Int Endod J. 2011;44(6):510-18.
23. Chevalier V, Arbab-Chirani R, Nicolas M, Morin V. Occurrence of no-function of two electronic apex locators: an in vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(6):e61–5.
24. Fouad A, Krell KV, McKendry DJ, Koorbusch GF, Olson RA. A clinical evaluation of five electronic root canal length measuring instruments. J Endod. 1990;16(9):446-49.
25. Gutmann JL. Origins of the electronic apex locator - achieving success with strict adherence to business. J Hist Dent. 2017;65(1):2-6.
26. Leonardo MR, Leal JM. Endodontia: tratamento     dos     canais radiculares. 3. ed. São Paulo: Panamericana; 1998.
27. 27.              Brunini SHS, Lima MC, Schmidt AC, Santos LR, Bonicontro CMC. Comparação in vitro da eficiência de dois localizadores apicais eletrônicos. Dent press endod. 2014;4(1):15-20.
28. Mandlik J, Shah N, Pawar K, Gupta P, Singh S, Shaik SA. An in vivo evaluation of different methods of working length determination. J Contemp Dent Pract. 2013;14(4):644-48.
29. Wrbas KT, Ziegler AA, Altenburger MJ, Schirrmeister JF. In vivo comparison of working length determination with two electronic apex locators. Int Endod J. 2007;40(2):133-38.
30. Duran-Sindreu  F, Stöber  E, Mercadé  M, Vera  J, Garcia M, Bueno R et al. Comparison of In Vivo and In Vitro Readings When Testing the Accuracy of the Root ZX Apex Locator. J Endod. 2012;38(2):236-39.
31. Duran-Sindreu F, Gomes S, Stöber E, Mercadé M, Jané L, Roig M. In vivo evaluation of the iPex and Root ZX electronic apex locators using various irrigants. Int Endod J. 2013;46(8):769-74.
32. Bernardes RA, Duarte MA, Vasconcelos BC, Moraes IG, Bernardineli N, Garcia RB et al. Evaluation of precision of length determination with 3 electronic apex locators:  Root ZX, Elements Diagnostic Unit and Apex Locator, and  RomiAPEX D-30. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(4):91-4.
33. Tselnik M, Baumgartner JC, Marshall JG. An evaluation of root ZX and elements diagnostic apex locators. J Endod. 2005;31(7):507-9.
34. Pishipati KVC. A in vitro comparison of propex II apex locator to standard radiographic method. Iran Endod J. 2013;8(3):114-17.
35. Cianconi L, Angotti V, Felici R, Conti G, Mancini M. Accuracy of three electronic apex locators compared with digital radiography: an ex vivo study. J Endod. 2010;36(12):2003–7.
36. Vasconcelos BC, Bueno Mde M, Luna-Cruz SM, Duarte MA, Fernandes CA. Accuracy of five electronic foramen locators with different operating systems: an ex vivo study. J Appl Oral Sci. 2013;21(2):132-37
37. 37.              Tampelini FG, Coelho MS, Rios MA, Fontana CA, Rocha DGP, Pinheiro SLB, et al. In vivo assessment of accuracy of Propex II, Root ZX II, and radiographic measurements for location of the major foramen. Restor Dent Endod. 2017; 42(3):200-5.
38. Vasconcelos BC, Araújo RBR, SilvaFCFA, Luna-CruzSM, DuarteMAH,^, FernandesCAO. In vivo accuracy of two electronic foramen locators based on different operation systems. Braz Dent J. 2014; 25(1):12-6.
39. Guimarães BM, Marciano MA, Amoroso-Silva PA, Alcalde MP, Bramante CM, Duarte MAH. O uso dos localizadores foraminais na endodontia: revisão de literatura. Rev Odontol Bras Central. 2014;23(64):2-7.
40. Renner D, Grazziotin-Soares R, Gavini G, Barletta FB. Influence of pulp condition on the accuracy of an electronic foramen locator in posterior teeth: an in vivo study. Braz Oral Res. 2012;26(2):106-11.
41. George R. Precision of multi-frequency electronic apex locators. Evid Based Dent. 2016;17(3):86-7.
42. Tsesis I, Blazer T, Ben-Izhack G, Taschieri S, Del Fabbro M, Corbella S et al. The precision of electronic apex locators in working length determination: a systematic review and meta-analysis of the literature. J Endod. 2015;41(11):1818-23.
43. Akisue E, Gratieri SD, Barletta FB, Caldeira CL, Grazziotin-Soares R, Gavini G. Not all electronic foramen locators are accurate in teeth with enlarged apical foramina: an in vitro comparison of 5 brands. J Endod. 2014;40(1):109-12.
44. Meares WA, Steiman HR. The influence of sodium hypochlorite irrigation on the accuracy of the Root ZX electronic apex locator. J Endod. 2002;28(8):595-98.
45. Khandewal D, Ballal NV, Saraswathi MV. Comparative Evaluation of Accuracy of 2 Electronic Apex Locators with Conventional Radiography: An Ex vivo Study. J Endod. 2015;41(2):201-4.
46. Orosco FA, Bernardineli N, Garcia RB, Bramante CM, Duarte MAH, Moraes IG. In vivo accuracy of conventional and digital radiographic methods in confirming root canal working length determination by Root ZX. J Appl Oral Sci. 2012;20(5):522-25.
47. Jarad FD, Albadri S, Gamble C, Burnside G, Fox K, Ashley JR et al.  Working length determination in general dental practice: a randomised controlled trial.  Br Dent J. 2011;211(12):595-98.
48. Kara Tuncer A, Gerek M. Effect of Working Length Measurement by Electronic Apex Locator or Digital Radiography on Postoperative Pain: A Randomized Clinical Trial. J Endod. 2014;40(1):38-41.
49. Kim E, Lee SJ. Electronic apex locator. Dent Clin North Am. 2004;48(1):35-54.
50. Kim YJA, Chandler NP. Determination of working length for teeth with wide or immature apices: a review. Int Endod J. 2013;46(6):483-91.
51. Martins JN, Marques D, Mata A, Caramês J. Clinical efficacy of electronic apex locators: systematic review. J Endod. 2014;40(6):759-77.