Avaliação de características dentinárias, decisão terapêutica pulpar e utilização de remoção seletiva de dentina cariada em lesões cariosas profundas por estudantes de odontologia e cirurgiões dentistas
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Data
2018-11-23
Autores
Tessarin, Fernanda Bastos Pereira [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do estudo foi avaliar a percepção de cirurgiões dentistas e alunos de graduação em Odontologia, em relação as características da dentina cariada remanescente (coloração, consistência e tipo de dentina) em lesão cariosa profunda, por meio de um estudo visual e tátil com aplicação de questionário, e relacionar com a decisão terapêutica pulpar escolhida em cada caso. Além disso avaliou-se a utilização clínica diária de remoção seletiva da dentina cariada, associando as respostas ao tempo de formação/atuação dos cirurgiões dentistas. Foram utilizados 12 molares humanos extraídos com lesão cariosa profunda. Os dentes foram divididos em três grupos (dentina sadia, dentina afeta e dentina infectada). Os dentes foram seccionados no sentido mésio-distal, uma das metades foi utilizada para a realização dos testes observacionais e tátil, com aplicação de questionários, a outra hemi-secção foi utilizada para a realização de testes laboratoriais (KHN e EDS). Os questionários foram respondidos por 45 observadores: 15 alunos de graduação, 15 cirurgiões dentistas com até 5 anos de formação e 15 cirurgiões dentistas com mais de 5 anos de formação. Com o auxílio de um explorador os observadores analisaram as dentinas remanescentes e responderam a 2 questionários. Os dados do teste visual e tátil com aplicação de questionário, foram submetidos ao teste Chi-quadrado (p<0,05). A etapa laboratorial foi analisada pelo teste de ANOVA em dois critérios, e pelo teste de Tukey (p<0,05). O teste Chi-quadrado mostrou diferenças para todos as características da dentina avaliada para todos os grupos, sendo que a dentina afetada/macia foi a que obteve menores índices de acerto. A decisão terapêutica pulpar mostrou diferenças estatísticas entre todos os grupos de dentina e de observadores, sendo as maiores escolhas positivas para utilização de proteção pulpar foi para o grupo de dentina amolecida e para o grupo de alunos. Os alunos de graduação relataram ter dificuldades de saber o momento de parar a escavação da dentina cariada. A remoção total do tecido cariado foi a técnica escolhida entre os grupos de cirurgiões dentistas.
The aim of this study was to evaluate the perception of dentists and undergraduate dental students in relation to the characteristics of remaining dentin (color, consistency and type of dentin) in deep carious lesion, through a visual and tactile study with application of questionnaire, and to relate to the pulp therapeutic decision in each case. Also the daily clinical use of selective carious dentin removal was assessed according to the time of practice. Twelve extracted human molars with deep carious lesion were used. The teeth were divided into three groups (healthy dentin, affected dentin and infected dentin). The teeth were sectioned in a mesialdistal direction, one half was used for the observational and tactile tests, and questionnaires, the other hemi-section was used for the laboratory testing (KHN and SDS). Questionnaires were completed by 45 observers: 15 undergraduate students, 15 dentists with up to five years of training and 15 dentists with more than 5 years of training. The observers analyzed the remaining dentin and answered 2 questionnaires. Visual and tactile data were submitted to Chi-square test (p <0.05). The laboratory data were analyzed by the two-way ANOVA, and by the Tukey test (p <0.05). The Chi-square test showed differences for all the characteristics of the dentin evaluated for all groups, and the affected / soft dentin was the one obtaining the lowest indexes of right answers. The pulp therapeutic decision showed statistical differences between all dentin groups and observers, with the largest positive choices for indicating pulp protection was to the softened dentin group and the group of students. Undergraduate students reported having difficulty knowing the time for stopping the carious dentin removal. The total removal of the carious tissue was the technique chosen among the groups of dentists.
The aim of this study was to evaluate the perception of dentists and undergraduate dental students in relation to the characteristics of remaining dentin (color, consistency and type of dentin) in deep carious lesion, through a visual and tactile study with application of questionnaire, and to relate to the pulp therapeutic decision in each case. Also the daily clinical use of selective carious dentin removal was assessed according to the time of practice. Twelve extracted human molars with deep carious lesion were used. The teeth were divided into three groups (healthy dentin, affected dentin and infected dentin). The teeth were sectioned in a mesialdistal direction, one half was used for the observational and tactile tests, and questionnaires, the other hemi-section was used for the laboratory testing (KHN and SDS). Questionnaires were completed by 45 observers: 15 undergraduate students, 15 dentists with up to five years of training and 15 dentists with more than 5 years of training. The observers analyzed the remaining dentin and answered 2 questionnaires. Visual and tactile data were submitted to Chi-square test (p <0.05). The laboratory data were analyzed by the two-way ANOVA, and by the Tukey test (p <0.05). The Chi-square test showed differences for all the characteristics of the dentin evaluated for all groups, and the affected / soft dentin was the one obtaining the lowest indexes of right answers. The pulp therapeutic decision showed statistical differences between all dentin groups and observers, with the largest positive choices for indicating pulp protection was to the softened dentin group and the group of students. Undergraduate students reported having difficulty knowing the time for stopping the carious dentin removal. The total removal of the carious tissue was the technique chosen among the groups of dentists.
Descrição
Palavras-chave
Dentina cariada, Intervenção mínima, Técnica ultraconservadora, Percepção visual, Percepção tátil, Carious dentin, Minimal intervention, Ultraconservative technique, Visual perception, Tactile perception