Desobturação endodôntica: revisão de literatura.

Abstract

Endodontic desobturation is necessary when there is a failure in a previous endodontic treatment that may result in the permanence of an unfavorable periapical condition. The goal is to remove any root canal filling material completely in order to achieve sufficient cleaning and shaping resulting in successful retreatment. Methods using manual files have long been advocated as being effective for this function. However, rotary and reciprocating instruments were proposed as an alternative to manual instrumentation, aiming at reducing the amount of residual plug material and optimizing the work time spent during the procedure. The purpose of this work is to review and discuss the literature on the quality of endodontic unclogging techniques, including both manual and automated techniques, associated or not with organic solvents. The databases PubMed, Medline, Bireme, Lilacs and BBO – Dentistry and Scielo were consulted, from which articles published with no language restriction were selected between the years 2010 and 2018. Among the techniques found in the literature, the following stand out: Hedströem and Kerr type hand files; rotary and reciprocating instruments, whether or not specially developed for endodontic retreatment; the association of chemical solvents and Gates Glidden drills, and complementation with ultrasound-activated irrigators. It is concluded that none of the described techniques were able to perform complete cleaning of the root canals, the manual method being as effective as the automated method, although it requires a longer working time. In addition, while it was verified that the solvent action did not allow a significant improvement in the quality of the disintegration, the ultrasound-activated irrigation proved to be an efficient complement, since it was able to significantly reduce the volume of intracanal remnant.