Análise radiográfica das aberturas endodônticas de dentes de pacientes referenciados a um Centro de Especialidades Odontológicas Radiographic analysis of endodontic access of patients referenced to a Center of Dental Specialities

Abstract

Introduction: Coronary access is the first stage of endodontic treatment and aims at direct access to root canals. Objective: To evaluate, by radiographic analysis, endodontic access cavities through radiographic analysis of the teeth of patients coming from primary care referred to the Center of Dental Specialties (CEO) Positivo, Curitiba, PR, Brazil. Material and methods: A total of 226 periapical radiographs taken previous to attending the CDS were analyzed, from August 2015 to August 2017. Three trained and calibrated examiners verified the following criteria: oral cavity region, presence of remaining caries,removal of roof of the pulp chamber, compensatory mesiodistal wear, iatrogenic (suggestive) and temporary restoration. Data were tabulated and analyzed for distribution, followed by bivariate analysis (Fisher’s Exact Test) with significance of 5%. Results: The posterior region prevailed in 70.3% of the sample. There remaining caries were found in 14.2%, insufficient roof removal in 25.2%, iatrogenic in 35.4%, and inadequate height of the temporary restoration in 11.5% of the cases. In the posterior teeth, insufficient mesiodistal compensatory wear was identified in 35.4 of the exams. The bivariate analysis revealed no significant difference when the variable region of the oral cavity was analyzed in relation to the presence of caries (p = 0.393), remaining roof (p = 0.056) and presence of iatrogenic (p = 0.304). Conclusion: It is concluded that there are relevant failures in the endodontic access received in the CDS, which indicates the need for professional training in primary care.