Correlação entre as reações histológicas de esmalte e dentina em lesões cariosas proximais: comparação entre estereomicroscopia e radiomicrografia como técnicas de validação.

• Autor(a) principal: Pinto, Laryssa de Barros
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/14133
• topic: Cárie dentária; Esmalte dental; Dentina; Histologia; Dental cavity; Dental enamel; Dentin; Histology; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA

Introduction: The current consensus is that the first dentin reaction to the carious process is dentin sclerosis, which begins when the carious lesion still partially advances in the dental enamel layer, and as the carious lesion advances in the enamel and dentin, before the stage Of cavitation, most underlying dentin layer is sclerotic, blocking and / or drastically reducing the transport of liquids from the pulp chamber to the enamel. Such consensus, which has important implications for noninvasive treatment strategies, is based on histopathological analysis of dentin reactions performed with stereomicroscopy (MS), which has many biases that interfere with the detection of sclerosed and carious dentin. Areas detected as sclerotic dentin and / or dentin normal to MS may present as areas of carious dentin at radiomicrographic examination. In this context, it is important to reevaluate the correlation between enamel and dentin reactions in proximal carious lesions. Objectives: The objectives of this study were to test two null hypotheses: (I) stereomicroscopy (MS) as well as radiomicrography with contrast solution of potassium iodide and mercury iodide (Thoulet solution with refractive index 1.47) (RxTh) result In a similar correlation between enamel and dentin reactions in natural non-cavitary proximal carious lesions (ICDAS scores 1-3); And (II) EM and RxTh detect equal proportions of maximum dentin reaction severity in proximal carious lesions. Methods: A total of 91 human teeth, premolars and molars, with proximal carious lesion, distributed according to the ICDAS scores of 0 to 3 were selected. The teeth were sectioned transversely, 2 cm below the cementoenamel junction, with the objective of separating the crowns from the roots and removing the pulp tissue. After removal of the pulps, the pulp chambers of lesions with ICDAS 3 scores were filled with radiographic contrast solution to check for RxTh at different time intervals whether or not there was displacement of the liquid to the enamel. Afterwards, histological sections (~ 1 mm thickness) were analyzed by a calibrated evaluator (Kappa of 0.81), regarding the extent of enamel reactions (through MS alone) and dentin (through both MS and RxTh, in the latter after immersion for 24 h in contrast solution). Results: The experiment of the displacement of the contrast solution in the intact crowns revealed an easy transport from the pulp chamber to the enamel of the proximal carious lesion. Spearman correlations between enamel and dentin reactions were 0.6541 (ME) and 0.2376 (RxTh), being statistically significant the difference between them (p = 0.0001, test Z), magnitude of effect q of 0 , 54 (95% unicaudal confidence interval: 0.61 / 0.22) and statistical power of 97.4%. Conclusion: It can be concluded that the use of RxTh results in a correlation between enamel and dentin reactions in proximal carious lesions that is much smaller than the use of MS, and that RxTh detects a much higher proportion of maximum dentin reaction in carious lesion Proximal.