RESUMEN
Introduction and Objective: The aim of this study was to investigate whether the sequelae arising from dental trauma in permanent teeth were influenced by the use or non-use of a clinical protocol, in emergency care treatment facilities in the city of Joinville/SC, Brazil. Material and methods: From 2008 to 2010, a total of 70 dental records were reviewed and evaluated 6 months after the completion of treatment. In addition to the data relating to gender, age, etiology, most affected teeth, and most prevalent traumas, the individuals were divided into 2 groups to compare the sequelae observed following either the use or non-use of a clinical protocol for dental trauma treatment. Results: There was a greater incidence of male patients, particularly in the age-range of 8 to 15 years. Falls were the most frequent cause of trauma. The total success rate of the emergency care was of 78.57%. In the group in which the protocol was used, the success rate reached 88.89% compared to 60.0% in the group in which the protocol was not used. Conclusion: The use of a clinical protocol positively influenced the sequelae arising after treatment for dental trauma.
RESUMEN
A polpa, diante de um fator agressor, apresenta reações inflamatórias ou degenerativas. Estas dependem do tipo, da frequência e da intensidade do agente irritante, assim como da resposta imune do paciente. Se o agente agressor não for removido, a polpa alterada ficará calcificada ou necrosada. Quando uma alteração pulpar está presente e não é tratada, poderá evoluir para a necrose pulpar. A necrose pulpar consiste na completa cessação dos processos metabólicos do tecido pulpar e, se não for removida, os produtos tóxicos bacterianos e da decomposição tecidual vão agredir os tecidos periapicais, dando início às alterações periapicais. O profissional deve ter conhecimento sobre as características histológicas, clínicas e radiográficas dessas patologias para poder reconhecê-las e indicar a melhor opção de tratamento.
The pulp undergoes inflammatory or degenerative reactions when submitted to an aggressive factor. These depend on the type, frequency and intensity of the irritant as well as the patient's immune response. If the aggressive agent is not removed, the pulp will either show calcifications or result in necrosis. This latter would occur when a pulp alteration is present and not treated. Pulp necrosis is the complete cessation of the tissue's metabolic processes. If it is not removed, the bacterial and the tissue decomposition's toxic products will injure the periapical tissues, resulting in periapical alterations. The dentist must know the histological, clinical and radiographic features of these pathologies to recognize them and indicate the best treatment option.
RESUMEN
This study used a mechanical test to evaluate the flexibility of instruments from the K3 (conicity 0.04) and the ProTaper Universal systems when they were new and after 5 uses in simulated canals. Five sets of instruments of each system were tested: K3 (15, 20, 25, 30, 35, 40 and 45) and ProTaper Universal (S1, S2, F1, F2, F3, F4 and F5). Each set of instruments was used to prepare a simulated canal and the same set of instruments was used 5 times (50 canals). The number of each subgroup represented the number of uses: 0 (control), 1, 3 and 5 uses. Before and after each use, the instruments were submitted to a mechanical flexibility test performed in a Versat 502 universal testing machine. Interactions between the instrument and the number of uses were analyzed by ANOVA and Tukey's test at a 5 percent level of significance. Instruments from both systems presented lower flexibility after the third use compared to the flexibility obtained after uses 0 and 1 (p<0.05), and maintained the same flexibility after the fifth use. The flexibility of instruments from the K3 system decreased with the increase of diameter, irrespective of the number of uses. Among the instruments from the ProTaper Universal system, the shaping files presented greater flexibility than the finishing files. F2 and F3 were the least flexible instruments, and F4 and F5 presented flexibility values similar to those of F1.
Esta pesquisa estudou a flexibilidade de instrumentos do Sistema K3 (conicidade 0.04) e do Sistema ProTaper Universal, por meio de um teste mecânico, quando os instrumentos eram novos e após 5 usos em canais simulados. Cinco jogos de instrumentos de cada sistema foram testados, como segue: grupo I - K3 (15, 20, 25, 30, 35, 40 e 45), e grupo II - ProTaper Universal (S1, S2, F1, F2, F3, F4 e F5). Cada jogo de instrumento foi usado para preparar um canal simulado, e o mesmo jogo de instrumento foi usado 5 vezes (50 canais). O número de cada subgrupo representou o número de usos: 0 (controle), 1, 3 e 5 usos. Antes do uso e depois de cada uso os instrumentos foram submetidos a um teste mecânico de flexibilidade realizado na máquina de ensaios universais Versat 502. A interação entre o instrumento e o número de usos foi analisada pelo ANOVA e pelo teste de Tukey ao nível de significância 5 por cento. Instrumentos de ambos os sistemas apresentaram menor flexibilidade após o terceiro uso quando comparada com a flexibilidade após os usos 0 e 1 (p<0,05), e mantiveram a mesma flexibilidade após o quinto uso. A flexibilidade dos instrumentos do sistema K3 diminuiu conforme o aumento de diâmetro, independente do número de usos. Entre os instrumentos do sistema ProTaper Universal, os shaping apresentaram maior flexibilidade que os finishing. F2 e F3 foram os menos flexíveis e F4 e F5 apresentaram valores de flexibilidade similares ao F1.