Siglo XXI: La filosofía de una Odontología mínimamente invasiva, lo que cambió del diagnóstico al tratamiento de la caries dental?

Autores/as

DOI:

https://doi.org/10.33448/rsd-v10i12.20385

Palabras clave:

Caries Dentales, Restauración Dental Permanente, Pruebas de Actividad de Caries Dental, Susceptibilidad a Caries Dentarias.; Caries dentales; Restauración dental permanente; Pruebas de actividad de caries dental; Susceptibilidad a caries dentarias.

Resumen

Introducción: La caries dental es la enfermedad más común a nivel mundial que influye negativamente en la calidad de vida de las personas. Con el avance de las investigaciones, el diagnóstico de lesiones cariosas y el uso de materiales y técnicas ha adquirido un carácter más conservador. Objetivo: Evaluar, a través de la evidencia científica disponible en la literatura, las propuestas actuales de intervenciones y protocolos para el tratamiento de la caries, con el objetivo de máxima preservación y mínima intervención en la estructura dentaria. Metodología: Selección de artículos en las bases de datos, MEDLINE (Sistema Online de Análisis y Recuperación de Literatura Médica), PUBMED. De las palabras clave “caries”, “parcial” y “remoción”, se preseleccionaron 50 artículos (2010 a 2021). Siguiendo los criterios de inclusión y exclusión, se seleccionaron y analizaron 17 artículos según el manejo de las lesiones, observando la gravedad, el grado de actividad de la caries y el tipo de material y técnica a utilizar. Resultados: Los estudios demuestran una mayor comprensión de la evolución de la caries, el establecimiento de un diagnóstico más cuidadoso y el desarrollo de materiales adhesivos y bioactivos han permitido tratamientos mínimamente invasivos. Se han encontrado diferencias significativas entre la remoción total, parcial y en 2 pasos (paso a paso) del tejido cariado. siendo que la remoción total y en 2 pasos aumentan las posibilidades de lesión y / o comunicación pulpar. Conclusión: La evolución de los materiales adhesivos y una mayor comprensión del desarrollo de la caries posibilita el uso de técnicas y materiales que garantizan una menor intervención y un mayor éxito clínico.

Citas

Bader, J. D., Shugars, D. A., & Bonito, A. J. (2001). A systematic review of selected caries prevention and management methods. Community Dentistry and Oral Epidemiology, 29(6), 399–411. https://doi.org/10.1034/J.1600-0528.2001.290601.X

Banerjee, A. (2012). “MI” caries management--an overview. Annals of the Royal Australasian College of Dental Surgeons, 21, 43–48.

Banerjee, A., & Doméjean, S. (2013). The contemporary approach to tooth preservation: minimum intervention (MI) caries management in general practice. Primary Dental Journal, 2(3), 30–37. https://doi.org/10.1308/205016813807440119

Bjørndal, L., Fransson, H., Bruun, G., Markvart, M., Kjældgaard, M., Näsman, P., Hedenbjörk-Lager, A., Dige, I., & Thordrup, M. (2017). Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up. Journal of Dental Research, 96(7), 747–753. https://doi.org/10.1177/0022034517702620

Coelho, A. S. E. da C., Mata, P. C. M., Lino, C. A., Macho, V. M. P., Areias, C. M. F. G. P., Norton, A. P. M. A. P., & Augusto, A. P. C. M. (2019). Dental hypomineralization treatment: A systematic review. Journal of Esthetic and Restorative Dentistry : Official Publication of the American Academy of Esthetic Dentistry ... [et Al.], 31(1), 26–39. https://doi.org/10.1111/JERD.12420

Corralo, D. J., & Maltz, M. (2013). Clinical and ultrastructural effects of different liners/restorative materials on deep carious dentin: a randomized clinical trial. Caries Research, 47(3), 243–250. https://doi.org/10.1159/000345648

Cushley, S., Duncan, H. F., Lappin, M. J., Chua, P., Elamin, A. D., Clarke, M., & El-Karim, I. A. (2021). Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta-analysis. International Endodontic Journal, 54(4), 556–571. https://doi.org/10.1111/IEJ.13449

Dimitraki, D., Papageorgiou, S. N., & Kotsanos, N. (2019). Direct pulp capping versus pulpotomy with MTA for carious primary molars: a randomised clinical trial. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 20(5), 431–440. https://doi.org/10.1007/S40368-019-00419-7

Elhennawy, K., Krois, J., Jost-Brinkmann, P. G., & Schwendicke, F. (2019). Outcome and comparator choice in molar incisor hypomineralisation (MIH) intervention studies: A systematic review and social network analysis. BMJ Open, 9(8). https://doi.org/10.1136/BMJOPEN-2018-028352

Feldens, C. A., Ardenghi, T. M., Dullius, A. I. D. S., Vargas-Ferreira, F., Hernandez, P. A. G., & Kramer, P. F. (2016). Clarifying the Impact of Untreated and Treated Dental Caries on Oral Health-Related Quality of Life among Adolescents. Caries Research, 50(4), 414–421. https://doi.org/10.1159/000447095

Frencken, J. E., Peters, M. C., Manton, D. J., Leal, S. C., Gordan, V. V, & Eden, E. (2012). Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. International Dental Journal, 62(5), 223–243. https://doi.org/10.1111/IDJ.12007

GBD, G. B. of D. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England), 392(10159), 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7

Giacaman, R. A., Muñoz-Sandoval, C., Neuhaus, K. W., Fontana, M., & Chałas, R. (2018). Evidence-based strategies for the minimally invasive treatment of carious lesions: Review of the literature. Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University, 27(7), 1009–1016. https://doi.org/10.17219/ACEM/77022

Hayashi, M., Fujitani, M., Yamaki, C., & Momoi, Y. (2011). Ways of enhancing pulp preservation by stepwise excavation--a systematic review. Journal of Dentistry, 39(2), 95–107. https://doi.org/10.1016/J.JDENT.2010.10.012

Hernández, M., Cobb, D., & Jr, E. J. S. (2014). Current strategies in dentin remineralization. Journal of Esthetic and Restorative Dentistry : Official Publication of the American Academy of Esthetic Dentistry ... [et Al.], 26(2), 139–145. https://doi.org/10.1111/JERD.12095

Hoefler, V., Nagaoka, H., & Miller, C. S. (2016). Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: A Systematic Review. Journal of Dentistry, 54, 25–32. https://doi.org/10.1016/J.JDENT.2016.09.009

Ismail, A. I., Sohn, W., Tellez, M., Amaya, A., Sen, A., Hasson, H., & Pitts, N. B. (2007). The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dentistry and Oral Epidemiology, 35(3), 170–178. https://doi.org/10.1111/J.1600-0528.2007.00347.X

Khokhar, M., & Tewari, S. (2018). Outcomes of Partial and Complete Caries Excavation in Permanent Teeth: A 18 Month Clinical Study. Contemporary Clinical Dentistry, 9(3), 468–473. https://doi.org/10.4103/CCD.CCD_344_18

Kidd, E. (2000). The Cartwright Prize. Caries removal and the pulpo-dentinal complex. Dental Update, 27(10), 476–482. https://doi.org/10.12968/DENU.2000.27.10.476

Lee, H., Chalmers, N. I., Brow, A., Boynes, S., Monopoli, M., Doherty, M., Croom, O., & Engineer, L. (2018). Person-centered care model in dentistry. BMC Oral Health, 18(1). https://doi.org/10.1186/S12903-018-0661-9

Loomans, B. A. C., Kreulen, C. M., Huijs-Visser, H. E. C. E., Sterenborg, B. A. M. M., Bronkhorst, E. M., Huysmans, M. C. D. N. J. M., & Opdam, N. J. M. (2018). Clinical performance of full rehabilitations with direct composite in severe tooth wear patients: 3.5 Years results. Journal of Dentistry, 70, 97–103. https://doi.org/10.1016/J.JDENT.2018.01.001

Lygidakis, N. A. (2010). Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation (MIH): A systematic review. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 11(2), 65–74. https://doi.org/10.1007/BF03262715

Machiulskiene, V., Campus, G., Carvalho, J. C., Dige, I., Ekstrand, K. R., Jablonski-Momeni, A., Maltz, M., Manton, D. J., Martignon, S., Martinez-Mier, E. A., Pitts, N. B., Schulte, A. G., Splieth, C. H., Tenuta, L. M. A., Ferreira Zandona, A., & Nyvad, B. (2020). Terminology of Dental Caries and Dental Caries Management: Consensus Report of a Workshop Organized by ORCA and Cariology Research Group of IADR. Caries Research, 54(1), 7–14. https://doi.org/10.1159/000503309

Maltz, M., Garcia, R., Jardim, J. J., Paula, L. M. de, Yamaguti, P. M., Moura, M. S., Garcia, F., Nascimento, C., Oliveira, A., & Mestrinho, H. D. (2012). Randomized trial of partial vs. stepwise caries removal: 3-year follow-up. Journal of Dental Research, 91(11), 1026–1031. https://doi.org/10.1177/0022034512460403

Maltz, M., Jardim, J. J., Mestrinho, H. D., Yamaguti, P. M., Podestá, K., Moura, M. S., & Paula, L. M. de. (2013). Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results. Caries Research, 47(2), 103–109. https://doi.org/10.1159/000344013

Maltz, M., Koppe, B., Jardim, J. J., Alves, L. S., Paula, L. M. de, Yamaguti, P. M., Almeida, J. C. F., Moura, M. S., & Mestrinho, H. D. (2018). Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial. Clinical Oral Investigations, 22(3), 1337–1343. https://doi.org/10.1007/S00784-017-2221-0

Manton, D. (2013). Partial caries removal may have advantages but limited evidence on restoration survival. Evidence-Based Dentistry, 14(3), 74–75. https://doi.org/10.1038/SJ.EBD.6400948

Martignon, S., Bartlett, D., Manton, D. J., Martinez-Mier, E. angeles, Splieth, C., & Avila, V. (2021). Epidemiology of Erosive Tooth Wear, Dental Fluorosis and Molar Incisor Hypomineralization in the American Continent. Caries Research, 55(1), 1–11. https://doi.org/10.1159/000512483

Mattos, J., Soares, G. M., & Ribeiro, A. de A. (2014). Current status of conservative treatment of deep carious lesions. Dental Update, 41(5), 452–456. https://doi.org/10.12968/DENU.2014.41.5.452

Mendes, K. D. S., Silveira, R. C. de C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto - Enfermagem, 17(4), 758–764. https://doi.org/10.1590/S0104-07072008000400018

Mesko, M. E., Cenci, M. S., Loomans, B., Opdam, N., & Pereira-Cenci, T. (2016). Reabilitação oral do desgaste dentário severo com resina composta. Faculdade de Odontologia Da UPF, 21, 121–129. https://doi.org/doi.org/10.5335/rfo.v21i1.5023

Murdoch-Kinch, C. A., & McLean, M. E. (2003). Minimally invasive dentistry. Journal of the American Dental Association (1939), 134(1), 87–95. https://doi.org/10.14219/JADA.ARCHIVE.2003.0021

Ngo, H., & Opsahl-Vital, S. (2014). Minimal intervention dentistry II: part 7. Minimal intervention in cariology: the role of glass-ionomer cements in the preservation of tooth structures against caries. British Dental Journal, 216(10), 561–565. https://doi.org/10.1038/SJ.BDJ.2014.398

Nyvad, B., Machiulskiene, V., & Baelum, V. (1999). Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Research, 33(4), 252–260. https://doi.org/10.1159/000016526

Pozos-Guillén, A., Molina, G., Soviero, V., Arthur, R. A., Chavarria-Bolaños, D., & Acevedo, A. M. (2021). Management of dental caries lesions in Latin American and Caribbean countries. Brazilian Oral Research, 35(suppl 01), 1–22. https://doi.org/10.1590/1807-3107BOR-2021.VOL35.0055

Ricketts, D., Lamont, T., Innes, N. P., Kidd, E., & Clarkson, J. E. (2019). Operative caries management in adults and children. The Cochrane Database of Systematic Reviews, 7(7). https://doi.org/10.1002/14651858.CD003808.PUB4

Rindal, D. B., Gordan, V. V, Fellows, J. L., Spurlock, N. L., Bauer, M. R., Litaker, M. S., Gilbert, G. H., & Group, D. C. (2012). Differences between reported and actual restored caries lesion depths: results from The Dental PBRN. Journal of Dentistry, 40(3), 248–254. https://doi.org/10.1016/J.JDENT.2011.12.015

Rosa, W. L. O. da, Lima, V. P., Moraes, R. R., Piva, E., & Silva, A. F. da. (2019). Is a calcium hydroxide liner necessary in the treatment of deep caries lesions? A systematic review and meta-analysis. International Endodontic Journal, 52(5), 588–603. https://doi.org/10.1111/IEJ.13034

Sato, Y., & Fusayama, T. (1976). Removal of dentin by fuchsin staining. Journal of Dental Research, 55(4), 678–683. https://doi.org/10.1177/00220345760550042301

Singh, S., Mittal, S., & Tewari, S. (2019). Effect of Different Liners on Pulpal Outcome after Partial Caries Removal: A Preliminary 12 Months Randomised Controlled Trial. Caries Research, 53(5), 547–554. https://doi.org/10.1159/000499131

Slayton, R. L., Urquhart, O., Araujo, M. W. B., Fontana, M., Guzmán-Armstrong, S., Nascimento, M. M., Nový, B. B., Tinanoff, N., Weyant, R. J., Wolff, M. S., Young, D. A., Zero, D. T., Tampi, M. P., Pilcher, L., Banfield, L., & Carrasco-Labra, A. (2018). Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. Journal of the American Dental Association (1939), 149(10), 837-849.e19. https://doi.org/10.1016/J.ADAJ.2018.07.002

Souza, M. T. de, Silva, M. D. da, & Carvalho, R. de. (2010). Integrative review: what is it? How to do it? Einstein (São Paulo), 8(1), 102–106. https://doi.org/10.1590/S1679-45082010RW1134

Tedesco, T. K., Reis, T. M., Mello-Moura, A. C. V., Silva, G. S. da, Scarpini, S., Floriano, I., Gimenez, T., Mendes, F. M., & Raggio, D. P. (2020). Management of deep caries lesions with or without pulp involvement in primary teeth: a systematic review and network meta-analysis. Brazilian Oral Research, 35, 1–14. https://doi.org/10.1590/1807-3107BOR-2021.VOL35.0004

Tyas, M. J., Anusavice, K. J., Frencken, J. E., & Mount, G. J. (2000). Minimal intervention dentistry--a review. FDI Commission Project 1-97. International Dental Journal, 50(1), 1–12. https://doi.org/10.1111/J.1875-595X.2000.TB00540.X

Veiga, N., Pereira, C., & Amaral, O. (2015). Prevalence and Determinants of Dental Caries in Portuguese Children. Procedia - Social and Behavioral Sciences, 171, 995–1002. https://doi.org/10.1016/J.SBSPRO.2015.01.219

Villat, C., Attal, J.-P., Brulat, N., Decup, F., Doméjean, S., Dursun, E., Fron-Chabouis, H., Jacquot, B., Bolla, M. M., Plasse-Pradelle, N., Roche, L., Maucort-Boulch, D., Nony, P., Gritsch, K., Millet, P., Gueyffier, F., & Grosgogeat, B. (2016). One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: study protocol for a randomized controlled trial. Trials, 17(1). https://doi.org/10.1186/S13063-016-1484-0

Zhang, Q., Ou, Y.-J., & Zhang, L. (2017). Curative effects of partial caries removal in permanent molars with deep dental caries. Shanghai Kou Qiang Yi Xue = Shanghai Journal of Stomatology, 26(3), 321–323.

Publicado

26/09/2021

Cómo citar

SILVA, D. K. C. da .; MENEZES, C. F. S. .; BRITO, A. C. R.; LIMA, D. M. .; FIROOZMAND, L. M. . Siglo XXI: La filosofía de una Odontología mínimamente invasiva, lo que cambió del diagnóstico al tratamiento de la caries dental?. Research, Society and Development, [S. l.], v. 10, n. 12, p. e440101220385, 2021. DOI: 10.33448/rsd-v10i12.20385. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20385. Acesso em: 22 nov. 2024.

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