Evaluación clínica y microbiológica usando tres técnicas de eliminación de tejido cariado
DOI:
https://doi.org/10.47990/alop.v13i1.523Palabras clave:
caries, eficacia clinica, instrumentacion, agentes quimicosResumen
Objetivo: Comparar, la efectividad clínica y microbiológica, entre las técnicas de eliminación tradicional y químico-mecánicas, para el tratamiento de lesiones cavitadas abiertas no penetrantes en dientes primarios en niños de 4 a 8 años, analizándose 57 dientes primarios. Grupo I: técnica tradicional (19 piezas), Grupo II: Brix (18 piezas), Grupo III: Papacarie (20 piezas). Evaluación clínica (necesidad de anestesiar y tiempo de ejecución) los datos fueron asentados en cada historia clínica. Antes y después del procedimiento operatorio, se tomaron muestras de la cavidad con microbrush estéril, transportándolas en tioglicolato para analizar cuantitativamente el total de bacterias presente por mililitro, utilizando cultivos de agar sangre (base Columbia). La información fue tabulada y analizada estadísticamente mediante Análisis de la Variancia, pruebas de Tukey y de Chi Cuadrado, estableciéndose como criterio de significancia p≤0.05. La diferencia significativa en la cantidad de bacterias entre el grupo I (41.22 ± 4.45) y los grupos II y III (65.96 ± 4.33, 83.45 ± 4.57), reveló que el grupo I fue menos efectivo. En los grupos II y III no se requirió la utilización de anestesia, siendo significativa la diferencia en los niños de edad preescolar (4 y 5 años). El tiempo de ejecución para cada técnica manifestó mayor rapidez en elgrupo I (2.12 min ± 0.15) p˂0.0001. Las técnicas que utilizan algún agente químico permiten una mayor eliminación de bacterias durante la remoción de tejido cariado, sin recurrir a anestesia, por lo que pueden ser recomendadas como alternativa al tratamiento tradicional especialmente en niños pequeños.
Citas
MA Al-Zayer, LH Straffon, RJ Feigal, KB Welch, Indirect pulp treatment of primary posterior teeth: A retrospective study. Pediatr Dent. 2003 (25): 29-36. PMID: 12627699.
A Banerjee, JE Frencken, F Schwendicke, NPT Innes, Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. BDJ 2017 (3):215-222. doi: 10.1038 / sj.bdj.2017.672
S Listl, J Galloway, P A Mossey, W Marcenes, Global Economic Impact of Dental Diseases. J Dent Res 2015 (94):1355–1361. doi: 10.1177 / 0022034515602879
L Bjorndal, A Thylstrup, A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study. CDOE 1988 (26):122–8. doi: 10.1111 / j.1600-0528.1998.tb01938.x
CCC Ribeiro, LN Baratieri, J Perdigao, NMM Baratieri, AV Ritter, A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. Quintessence Int 1999 (30):591–9. PMID: 10765864
SL Handelman, Effect of sealant placement on occlusal caries progression. Clin Prev Dent 1982 (4):11-16. PMID: 6985276
EJ Mertz-Fairhurst, KM Call-Smith, GS Shuster, JE Williams, QB Davis, CD Smith, RA Bell, JD Sherrer, DR Myers, PK Morse, TA German, VI Della-Giustina, Clinical performance of sealed composite restorations placed over caries compared with sealed and unsealed amalgam restorations. J Am Dent Assoc 1987 (5):689-94. doi: 10.14219 / jada.archive.1987.0288
M Cortes, VGA Pecorari, RT Basting, FMG França, CP Turssi, FLB do Amaral, Effect of rotatory instrument speed on its capacity to remove demineralized and sound dentin. Eur J Dent 2013 (7): 429-435. doi: 10.4103 / 1305-7456.120676
S Mhatre, SVK Kumar, S Sinha, BMN Ahmed, EA Thanawala, Chemo-Mechanical Method Of Caries Removal: A Brief Review. Int J Clin Dent Sci 2011 (2):52-57. PMID: 11486517
KJ Heyeraas, OB Sveen, IA Major, Pulp-dentin biology in restorative dentistry. Part 3: Pulpal inflammation and its sequelae. Quintessence Int 2001 (32):611–625. PMID: 11526889
M Baghizadeh Fini, What dentists need to know about COVID-19. Oral Oncology 10.1016/j.oraloncology.2020.104741
SK Bussadori, CC Guedes, JC Bachiega, TO Santis, LJ Mota. Clinical and radiographic study of chemical-mechanical removal of caries using Papacárie: 24-month follow up. J Clin Pediatr Dent. 2011 35 (3):251-254. doi: 10.17796/jcpd.35.3.75803m02524625h5
MM Ammari, L Moliterno, Remoção químico-mecânica da cárie: evidências atuais. Rev Bras Odontol 2005 62 (1/2):125-7.
Muaaz M, SF Alkhouli. NG Al Nesser, AN Bshara, JC, AlMidani C, Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial. J Dent, 2020. https://doi.org/10.1016/j.jdent.2020.103280.
MI Mafaz Mahdi, MJ Aseel Haidar, BDS Al Haidar, Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city. J Bagh College Dentistry 2020 31(2):7-13.
Katiyar A, Gupta S, Gupta K, Sharma K, Tripathi B, Sharma N. Comparative Evaluation of Chemo-mechanical and Rotary-mechanical Methods in Removal of Caries with Respect to Time Consumption and Pain Perception in Pediatrc Dental Patients. Int J Clin Pediatr Dent. 2021 14(1):115-119. doi: 10.5005/jp-journals-10005-1896. PMID: 34326596; PMCID: PMC8311777.
CL Hicks, CL von Baeyer, PA Spafford, I van Korlaar, B Goodenough, The Face Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain 2001 93:173-83. doi: 10.1016 / S0304-3959 (01) 00314-1
MW LeChevallier, RJ Seidler, TM Evans, Enumeration and characterization of standard plate count bacteria in chlorinated and raw water supplies. Appl Environ Microbiol 1980 40(5):922-30. doi: 10.1128 / aem.40.5.922-930.1980
SF Al Nesser, NG Bshara, Evaluation of the apical extrusion of sodium hypochlorite gel in immature permanent teeth: an in vitro study. Dent Med Probl, 2019 56 (2):149–153. doi: 10.17219 / dmp / 103911
JA Aas, AL Griffen, SR Dardis, AM Lee, I Olsen, FE Dewhirst, EJ Leys, BJ Paster, Bacteria of dental caries in primary and permanent teeth in children and young adults. J Clin Microbiol 46 (4) (2008) 1407:17. doi: 10.1128 / JCM.01410-07
A Banerjee, EA Kidd, TF Watson, In vitro Evaluation of Five Alternative Methods of Carious Dentine Excavation. Caries Res 2000 34:144–50. doi: 10.1159 / 000016582
MR Bohari, YK Chunawalla, BMN Ahmed, Clinical Evaluation of Caries Removal in Primary Teeth using Conventional, Chemomechanical and Laser Technique: An in vivo Study. J Contemp Dent Pract, 2012 13:40–47. doi: 10.5005 / jp-journals-10024-1093
KR Felizardo; NP Alvarenga Barradas, GF Guedes, FCA Ferreira, MB Lopes, Use of BRIX-3000 Enzymatic Gel in Mechanical Chemical Removal of Caries: Clinical Case Report. J Health Sci, 2018 20(2):87-93 doi: http://dx.doi.org/10.17921/2447-8938.2018v20n2p87-93
M El-Tekeya, L El-Habashy, N Mokhles, E El-Kimary, Effectiveness of 2 chemomechanical caries removal methods on residual bacteria in dentin of primary teeth. Pediatr Dent 2012 34 (4):325-30. PMID: 23014090
LJ Motta, SK Bussadori, AP Campanelli, AL Silva, TA Alfaya, CH Godoy, MF Navarro de Lima, Efficacy of Papacarie® in reduction of residual bacteria in deciduous teeth: a randomized, controlled clinical trial. Clínics, 2014 69 (5):319-22. doi: 10.6061 / clínicas / 2014 (05) 04
SF Matsumoto, LJ Motta, TA Alfaya, CC Guedes, KP Fernandes, SK Bussadori, Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial. Indian J Dent Res 2013 24 (4):488–92. doi: 10.4103 / 0970-9290.118393
B Azrak, A Callaway, A Grunheber, E Stender, B Willershausen, Comparison of the efficacy of chemomechanical caries removal (Carisolv) with that of conventional excavation inreducing the cariogenic flora. Int J Paediatr Dent 2004 14 (3):182–19. doi: 10.1111 / j.1365-263X.2004.00535.x
J Yun, YS Shim, SY Park, SY An, New treatment method for pain and reduction of local anesthesia use in deep caries. J Dent Anesth Pain Med 2018 18(5): 277-285. doi: 10.17245 / jdapm.2018.18.5.277
PA Goyal, R Kumari, VP Kannan, S Madhu, Efficacy and tolerance of papain gel with conventional drilling method: a clinico-microbiological study. J Clin Pediatr Dent 2015 39:109–112. doi: 10.17796 / jcpd.39.2.n25754863557k727
NB Nagaveni, NB Radhika, TS Satisha, KS Ashwini, S Neni, S Gupta, Efficacy of new chemomechanical caries removal agent compared with conventional method in primary teeth: An in vivo study. Int J Oral Health Sci 2016 6:52–58. https://www.ijohsjournal.org/text.asp?2016/6/2/52/199986
Chowdhry S, S Saha, F Samadi, JN Jaiswal, A Garg, P Chowdhy, Recent vs conventional methods of caries removal: a comparative un vivo study in pediatrics patients. IJCPD, 2015 8(1):6-11. doi: b4e8e040f8f9315c99eaf65120d155677123.pdf
D Jawa, S Sigh, R Somani, S Jaidka, K Sirkar, R Jaidka, Comparative evaluation of the efficacy of chemomechanical caries removal agent (Papacarie) and conventional method of caries removal: an in vitro study. J Ind Soc Pedodont, 2010 28(2):73-77. doi: 10.4103 / 0970-4388.66739
J Yun, YS Shim, SY Park, SY An, New treatment method for pain and reduction of local anesthesia use in deep caries. J Dent Anesth Pain Med 2018 18(5): 277-285. doi:10.17245/jdapm.2018.18.5.277.
R Moore, H Birn, E Kirkegaard, I Brødsgaard, F Scheutz, Prevalence and characteristics of dental anxiety in Danish adults. Community Dent Oral Epidemiol 1993 21:292–296. doi: 10.1111 / j.1600-0528.1993.tb00777.x
AH Kim, ES Ahn, SY An, Factors affecting dental fear in Korean adolescents. J Korean Dent Sci 2017 10:22–28. https://www.researchgate.net/publication/322102688_Factors_Affecting_Dental_Fear_in_Korean_Adolescents
SK Bussadori, LC Castro, AC Galvão, Papain gel: a new chemo-mechanical caries removal agent. J Clin Pediatr Dent, 2005 30:115–119. doi: 10.17796 / jcpd.30.2.xq641w720u101048
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 Revista de Odontopediatría Latinoamericana
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
