Acesso conservador e suas implicações no tratamento endodôntico

##plugins.themes.bootstrap3.article.sidebar##

PDF
Publicado Jun 13, 2025
DOI https://doi.org/10.25248/reas.e20668.2025

##plugins.themes.bootstrap3.article.main##

Sophie Barbosa de Farias Gama
Universidade Federal de Alagoas
Clarice da Silva Santos
Erika Caroline Silva de Oliveira
Joyce da Silva
João Victor Pessoa da Silva Lins
Danielle de Oliveira Silva
Maisa Carla Lins Moura
Yole da Silva Batinga
Thamyres Cavalcante Costa
Daniel Pinto de Oliveira

Resumo

Objetivo: Descrever as implicações causadas no tratamento endodôntico pelos acessos endodônticos conservadores em relação aos acessos endodônticos tradicionais. Métodos: Foi realizada uma busca nas bases de dados PubMed, utilizando os termos “Root canal treatment”, “Dental Pulp Cavity” e “Conservative Treatment”. Foram priorizados artigos dos últimos onze anos na língua inglesa das revistas “Journal of Endodontics” e “International Endodontic Journal”. Resultados: Apesar da busca da Endodontia conservadora em preservar estruturas saudáveis, resultados indesejados podem ocorrer nas etapas subsequentes ao acesso endodôntico, como dificuldade no acesso à câmara pulpar, limitações na visualização, instrumentação, obturação e limpeza dos canais radiculares e, ainda, resistência à fratura sem diferença significativa em relação ao acesso tradicional. Considerações finais: Embora o acesso endodôntico conservador seja uma abordagem promissora, é importante destacar que ele pode apresentar limitações, uma vez que não há evidências de resistência à fratura aumentada em dentes com acessos conservadores quando comparados aos acessos tradicionais, bem como outras desvantagens relevantes durante o tratamento, logo não há motivo para optar por ele, sendo preferível o acesso tradicional.

##plugins.themes.bootstrap3.article.details##

Como Citar
GamaS. B. de F., SantosC. da S., OliveiraE. C. S. de, SilvaJ. da, LinsJ. V. P. da S., de Oliveira SilvaD., Lins MouraM. C., da Silva BatingaY., Cavalcante CostaT., & Pinto de OliveiraD. (2025). Acesso conservador e suas implicações no tratamento endodôntico. Revista Eletrônica Acervo Saúde, 25(6), e20668. https://doi.org/10.25248/reas.e20668.2025
Edição
v. 25 n. 6 (2025): Revista Eletrônica Acervo Saúde (ISSN 2178-2091) | Volume 25 (6) | 2025
Seção
Revisão Bibliográfica

Copyright © | Todos os direitos reservados.

A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.

Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.

Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.

Referências

1. ABOU-ENALGA MY, et al. Effect of truss access and artificial truss restoration on the fracture resistance of endodontically treated mandibular first molars. Journal of Endodontics, 2019; 45(6): 813-817.

2. AHMED HMA e GUTMANN JL. Education for prevention: a viable pathway for minimal intervention in endodontic treatment. ENDO - Endodontic Practice Today, 2015; 9(4): 283–285.

3. ALOVISI M, et al. Influence of contracted endodontic access on root canal geometry: an in vitro study. Journal of Endodontics, 2020; 44(4): 614-620.

4. BALLESTER B, et al. Current strategies for conservative endodontic access cavity preparation techniques-systematic review, meta-analysis, and decision-making protocol. Clin Oral Investig. Clin Oral Invest, 2021; 25(11): 6027–6044.

5. BARBOSA AFA, et al. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars. International Endodontic Journal, 2020; 53(12): 1666-1679.

6. CLARK D e KHADEMI J. Modern molar endodontic access and directed dentin conservation. Dent Clin North Am, 2010; 54(2): 249-273.

7. CORSENTINO G, et al. Influence of access cavity preparation and remaining tooth substance on fracture strength of endodontically treated teeth. Journal of Endodontics, 2018; 44(9): 1416-1421.

8. GLUSKIN AH, et al. Minimally invasive endodontics: challenging prevailing paradigms. Br Dent J, 2014; 216(6): 347-53.

9. JIANG Q, et al. Biomechanical properties of first maxillary molars with different endodontic cavities: a finite element analysis. Journal of Endodontics, 2018; 44(8): 1283-1288.

10. KRISHAN R, et al. Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars. Journal of Endodontics, 2014; 40(8): 1160-1166.

11. MARCHESAN MA, et al. Impacts of contracted endodontic cavities on primary root canal curvature parameters in mandibular molars. Journal of Endodontics, 2018; 44(10): 1558-1562.

12. MOORE B, et al. Impacts of contracted endodontic cavities on instrumentation efficacy and biomechanical responses in maxillary molars. Journal of Endodontics, 2016; 42(12): 1779–1783.

13. NEELAKANTAN P e KHAN K. Does the Orifice-directed Dentin Conservation Access Design Debride Pulp Chamber and Mesial Root Canal Systems of Mandibular Molars Similar to a Traditional Access Design? Journal of Endodontics, 2018; 44(2): 274-279.

14. ÖZYÜREK T, et al. The effects of endodontic access cavity preparation design on the fracture strength of endodontically treated teeth: traditional versus conservative preparation. Journal of Endodontics, 2018; 44(5): 800-805.

15. PEREIRA RD, et al. Impact of Conservative Endodontic Cavities on Root Canal Preparation and Biomechanical Behavior of Upper Premolars Restored with Different Materials. Journal of Endodontics, 2021; 47(6): 989-999.

16. PLOTINO G, et al. Fracture strength of endodontically treated teeth with different access cavity designs. Journal of Endodontics, 2017; 43(6): 995-1000.

17. ROVER G, et al. Influence of access cavity design on root canal detection, instrumentation efficacy, and fracture resistance assessed in maxillary molars. Journal of Endodontics, 2017; 43(10): 1657-1662.

18. ROVER G, et al. Influence of minimally invasive endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors. International Endodontic Journal, 2020; 53(11): 1530-1539.

19. SABER SM, et al. The effect of access cavity designs and sizes of root canal preparations on the biomechanical behavior of an endodontically treated mandibular first molar: a finite element analysis. Journal of Endodontics, 2020; 46(11): 1675-1681.

20. SABETI M, et al. Impact of access cavity design and root canal taper on fracture resistance of endodontically treated teeth: an ex vivo investigation. Journal of Endodontics, 2018; 44(9): 1402-1406.

21. SILVA AA, et al. Does ultraconservative access affect the efficacy of root canal treatment and the fracture resistance of two-rooted maxillary premolars? International Endodontic Journal, 2020; 53(2): 265-275.

22. VERTUCCI FJ e HADDIX JE. Tooth Morphology and access cavity preparation. Cohen's Pathways of the Pulp, 2011; 7: 136-222.

23. VIEIRA GCS, et al. Impact of Contracted Endodontic Cavities on Root Canal Disinfection and Shaping. Journal of Endodontics, 2020; 46(5): 655-661.

24. VORSTER M, et al. Effect of Different Endodontic Access Cavity Designs in Combination with WaveOne Gold and TruNatomy on the Fracture Resistance of Mandibular First Molars: A Nonlinear Finite Element Analysis. Journal of Endodontics, 2023; 49(5): 559-566.

25. YUAN K, et al. Comparative evaluation of the impact of minimally invasive preparation vs. conventional straightline preparation on tooth biomechanics: a finite element analysis, 2016; 124(6): 591-596.

26. ZHANG Y, et al. The effect of endodontic access cavities on fracture resistance of first maxillary molar using the extended finite element method. Journal of Endodontics, 2019; 45(3): 316-321.