Remoção de tecido cariado: Relações entre setor público e privado na conduta clínica dos cirurgiões-dentistas

Abstract

Dental caries is an oral disease of great prevalence among populations, being the main responsible for tooth loss of all ages. For the treatment of carious lesions, the removal of carious tissue is of paramount importance, as it is the step that precedes the restorative procedure. Selective Carious Tissue Removal (RSTC), Non-Selective Hard Dentin Removal (RNSDD) and Gradual Carious Tissue Removal (RGTC) are the main techniques used for the treatment of deep carious lesions. In this sense, the clinical procedure of dental surgeons may vary according to the conduct adopted by the professional. With the emergence and advancement of Minimally Invasive Dentistry, conservative intervention protocols, such as RSTC, have been advocated by current evidence, since the complete removal of the carious dentin substrate is not essential for controlling the progression of the disease. The objective of this study was to know and identify the clinical procedures used for the treatment of deep carious lesions by dentists working in the oral health system in Brazil, involving the public and/or private sector. It is a quantitative and transversal research. The research was carried out with 121 dentists in the Brazilian oral health system, using a Google Form, containing questions related to clinical criteria and techniques used in the treatment of deep caries lesions, materials and instruments used, survival rate of some treatments, as well as sociodemographic data and questions regarding professional qualification. Among the interviewees, the majority (53.7%) consider that the floor of the cavity must be hard at the end of the removal, which demonstrates the non-adherence to the RSTC protocols. Only 10.7% considered RSTC a treatment with chances of success and 2-year survival greater than 80%. Almost half of the interviewees (46.3%) disagreed with maintaining carious tissue in the axial/pulp walls of deep cavities to preserve pulp vitality. Low adherence to the RSTC technique was observed, with more invasive and radical techniques and clinical practices being preferred in the treatment of deep caries lesions.