Preparo automatizado dos canais radiculares em dentes decíduos

: uma umbrella review

Abstract

Background: Keeping the primary teeth in good anatomic and functional conditions, until the physiological exfoliation, it’s very important for a healthy development of the permanent dentition and the entire stomatognathic system. Injuries and extensive caries lesions may cause pulp involvement that will require treatment. Endodontic treatment and the different techniques for the instrumentation of the root canals of primary teeth, with manual or rotary instruments, are some of the possible treatments options. Aim: To assess, through an umbrella review, whether rotary instrumentation of root canals in primary teeth can already be safely used in clinical practice. Design: The literature considered was based on the PRISMA guidelines and aims to answer the following specific question constructed in the PICO format: ”In primary teeth in need of endodontic treatment and with rotary preparation in the root canals and compared to the conventional (manual) preparation method, what are the clinical benefits, for the patient and for the operator?”. The data sources were Medline/PubMed, Web of Science and Scopus, supplemented with a manual search. After the eligibility, inclusion and exclusion criteria, a descriptive analysis was performed with the extracted data. Methodological quality was assessed using the AMSTAR-2 tool, while risk of bias was assessed using ROBIS. Two reviewers (ACVMM and MPD) independently performed quality and risk of bias analyses. Results: A systematic search of the literature identified some potentially relevant references and, in a first analysis of the inclusion criteria, 40 publications were found. After applying the eligibility criteria, only 4 articles were included and analysed in their entirety. Regarding the main results, no systematic review reached a definitive conclusion about the best method of instrumentation of root canals in primary teeth. Conclusion: Rotary root canal preparation in primary teeth decreases clinical time, which is a benefit for treatment. The modelling carried out by the different kinematics and instrument designs facilitate the obturator technique and the filling, however there is no conclusion as to how much this characteristic brings a benefit or not to the treatment. The clinical and radiographic longevity of the treatment is similar between the manual and automated technique. This type of technical step is safe to use during endodontic treatment in primary teeth.

Date of Award	25 Jul 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Anna Moura (Supervisor) & Patrícia Nunes Correia (Co-Supervisor)