Título:	Avaliação longitudinal de métodos de remoção seletiva de tecido cariado em molares decíduos vitais e assintomáticos com lesões de cárie profundas
Autor(es):	Marques, Marta Gomes
Orientador(es):	Hilgert, Leandro Augusto
Assunto:	Cáries dentárias Distrito Federal (Brasil) - escolas públicas Odontologia Saúde pública
Data de publicação:	21-Ago-2024
Data de defesa:	14-Set-2023
Referência:	MARQUES, Marta Gomes. Avaliação longitudinal de métodos de remoção seletiva de tecido cariado em molares decíduos vitais e assintomáticos com lesões de cárie profundas. 2023. 118 f., il. Tese (Doutorado em Odontologia) — Universidade de Brasília, Brasília, 2023.
Abstract:	Introduction: Selective carious tissue removal is advocated to treat cavitated carious lesions not accessible to cleaning instruments and with signs of activity. This technique has different clinical approaches, depending on the depth of the carious lesion. The management of deep lesions is usually associated with professional therapeutic insecurity and with immediate or long-term pulpal complications. Objective: to compare, based on data from one and two years of follow-up, subjective versus objective criteria for selective removal of carious tissue in deep lesions. Method: This thesis is based on a community-based single-blind randomized controlled clinical trial. The sample consisted of vital and asymptomatic primary molars with deep caries lesions of students from six public schools in Paranoá – Federal District. Randomization was performed according to the selective removal protocol adopted: (O) objective protocol – selective removal with polymer burs and (S) subjective protocol – selective removal using hand excavation. The treatment was carried out in a mobile dental unit by two previously trained dentists and the evaluation by two calibrated examiners. Generalized linear models (GLM) and multi-level Cox-regression analysis were applied. Restoration success was evaluated according to ART criteria. Results: 115 children were treated (177 restorations, 91S, 86O). After two years, out of 136 restorations (71S, 65O), 50S and 48O were successful (ART criteria 0/1, no pulpal complications, no re-intervention needed, or tooth extraction) and 70 S and 65 O survived (tooth retained with or without further retreatments being needed, or tooth exfoliated). There were 9 cases of pulpal complications (7S, 2O). There was no significant difference in treatment time (mean; 95%CI – S:433s; 404– 462s; O:412s; 382-441s; p=0.378/GLM), immediate patient satisfaction (p=0.164) and risk of failure between O and S. The majority of failures were restorative, not pulpal, and distribution of ART codes was not significant differences between groups. Risk of failure was not significantly associated with the removal protocol, age, gender or dental arch (p>0.05/Cox). Greater risk of restorative failure was statistically associated with restorations involving multiple surfaces in 1-year-follow up (HR: 4.60; 95% CI: 1.70-12.4); and, in 2-years follow up single surfaced restorations still showed significantly reduced hazard (0.14; 0.06-0.37). Conclusion: Both protocols present clinical success for the management of deep carious lesions in deciduous teeth, considering pulp and non-pulpal complications.
Unidade Acadêmica:	Faculdade de Ciências da Saúde (FS)
Informações adicionais:	Tese (doutorado) — Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Odontologia, Programa de Pós-Graduação em em Odontologia, 2023.
Programa de pós-graduação:	Programa de Pós-Graduação em Odontologia
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