Estudo prospectivo de 2 anos sobre fatores associados ao reparo apical e dor pós-operatória em molares jovens tratados endodonticamente

Abstract

The faster progression of caries lesions in permanent molar teeth of young patients, frequently result in endodontic treatment. This prospective cohort study aimed to evaluate the incidence of pain and apical repair after endodontic treatment of young molar teeth and identify factors associated with treatment outcomes. Endodontic treatment was performed by undergraduate students in permanent molar teeth (n=75) of young patients (n=60) at the Endodontic and Restorative Extension Clinic of the Federal University of Uberlandia, Brazil. Protaper Next was used and two sealers (Sealer 26 and AH Plus) were randomly assigned in the samples, which were restored with direct composite resin. Two primary clinical outcomes – apical repair and postoperative pain, were assessed after 12 and 24 months. Analysis of longitudinal data included the description of incidence rates and mixed-model regression using Generalized Estimation Equations (GEE). After 2 years 69 molar teeth of 54 patients were evaluated. The incidences (%) of apical repair and asymptomatic teeth were respectively 90.5 and 89.3, 96.8 and 90.0 for 1- and 2-years follow-up. Failed apical repair was associated with unsatisfactory endodontic treatment (P=0.003) and periapical conditions (P=0.007) as well as their interaction (P=0.016). None of these independent variables was able to predict the occurrence of pain in follow-up periods. Endodontic treatment showed satisfactory results after 2 years. Prognosis of apical repair is dependent on the initial conditions. No effect of the endodontic sealer was observed. Endodontic treatment of young molars associated with composite restorations performed by undergraduate students, have a relevant role in reducing the risk of permanent teeth loss.