Avaliação da qualidade do tratamento endodôntico realizado com diferentes tipos de instrumentação

Abstract

The root canal system instrumentation is one of the most important stages of endodontic treatment, contributing to the reduction of microorganisms. Its correct execution is directly related to a satisfactory obturation, usually evaluated by imaging exams. Depending on the type of instrumentation used, the results obtained may vary, especially when evaluating the performance of dental students. The objective of the present study was to evaluate, through digital periapical radiographs, the quality of obturation in multiradicular teeth instrumented with different techniques by dental students. Eighty multiradicular human teeth were selected, which were cleaned and had their crowns removed. These were instrumented by four dentistry students. Of the 20 teeth instrumented by each student, 10 were instrumented with stainless steel hand files and 10 with nickel-titanium (Ni-Ti) rotary files. All teeth were filled by lateral condensation technique and subjected to periapical radiography examinations by the semi-direct digital acquisition system with photostimulable phosphor plates (PSP). The images were evaluated by experienced, previously instructed examiners, grading the quality of the obturation and whether complications occurred. To verify intra- and inter-rater agreement, the Kappa test was performed. To compare the quality of obturation between the different instrumentation techniques, the McNemar test was used (p <0.05). The evaluation of the instrumentation quality in relation to the length of the obturator material did not present significant difference for the two forms of instrumentation. Regarding the homogeneity of the obturator material, there was no significant difference either. Comparing the two techniques for the presence or absence of complications and the frequency of complications, the results were similar. (p> 0.05). It was concluded that the instrumentation performed by undergraduate apprentices was similar, regardless of whether hand-operated stainless steel or Ni-Ti rotary files are used, allowing the operator the freedom to choose the one that is most advantageous to the procedure to be performed without loss of quality.