Extrusão apical de Debris durante a desobturação endodôntica: revisão de literatura

Abstract

Endodontic retreatment is necessary to correct failures caused during the previous treatment, which can be due to several reasons, such as the inability to perform the first treatment, microbial factor, contamination of coronary restorations, preparations and unsuccessful endodontic fillings. The major challenge in endodontic retreatment is the removal of the obturator material from the root canal, a necessary step to perform a new treatment, this removal can be done with manual files, ultrasonic, rotary or reciprocating files, with or without the use of the solvent. However, materials apically extruded during this process are clinically responsible for postoperative inflammation and for flare-ups or even failures in apical healing. The objective of this work was to discuss the different techniques of removal of the root canal filling and the use or not of the solvent, the extrusion of debris and its consequences for the patient. Pubmed, Scielo and Bireme databases were consulted, inserting articles published in English and Portuguese, between the years of 2002 and 2018. Among the complications due to the extrusion of debris found in the literature are irritation, pain, discomfort and persistent inflammation, sometimes requiring medication and reintervention. Based on the literature review and discussion, it was possible to conclude that all techniques, regardless of movement and speed of rotation, extrude debris apically during endodontic debridement; The Protaper and Mtwo rotary techniques do not have statistically significant differences in the apically extruded debris, but they cause a lower extrusion of debris when compared to the manual; The manual technique is the one that causes a greater extrusion of debris apically when compared with the other techniques; Reciproc and WaveOne reciprocating techniques do not have statistically significant differences in the extrusion of detritus by the apical foramen, but they present a lower extrusion when compared to the manual technique; The use of solvents during filling removal reduces the amount of extruded debris apically.