Estudo retrospectivo e observacional do sucesso e insucesso no retratamento endodôntico de molares

Abstract

There is a high rate of unsatisfactory endodontic treatments, which makes a new intervention necessary, opting, in most cases, for non-surgical retreatment. Thus, the present study has aimed to evaluate, in a retrospective and observational way, the success and failure rate found in the endodontic retreatment of molars. In order to compose this work, 56 molars were analyzed, based on clinical data from dental records and digital x-rays, obtained at Clínica Particular EndoMais, located in Uberlândia, Minas Gerais. All retreatments investigated were carried out using an operating microscope and performed by a single endodontist, in the period between May 2012 and May 2023. The periapical index (PAI) was also used to complement the radiographic analysis by quantifying the presence of periapical changes. Four causes of failure in endodontic interventions have been recorded: intraradicular infection; extraradicular infection; foreign body reaction and true cyst. The results have demonstrated that before retreatment, 42.85% (n=24) of cases had clinical signs; and 46.42% (n=26), pathological symptoms. After retreatment, however, this number decreased to 12.5% (n=7) and 7.14% (n=4), respectively. In the radiographic examination, before retreatment, 87.5% (n=49) had a periapical lesion, 87.5% (n=49) had unsatisfactory filling of the root canals, all of which were sub fillings, and 35.71% had unsatisfactory coronary sealing. Also, after retreatment, periapical lesions were found in 28.57% (n=16) of cases. Furthermore, 32.14% (n=18) had an unsatisfactory filling, and 3.57% (n=2) showed unsatisfactory sealing. Prior to retreatment, the periapical index (PAI) which represents the presence of pathology (scores 3, 4 and 5) was present in 82.14% (n=46) of the cases, and afterwards, this value was reduced to 28.55% (n=16). In conclusion, the success rate of endodontic retreatment of molars occurred in 67.85% of cases whereas failure happened in 32.15%, and had as causal factors, in equal proportion, intraradicular infection, related to inadequate endodontic treatment and extraradicular infection.