Restauração de dentes tratados endodonticamente: recomendações para a prática clínica e para o reporte de pesquisas

Abstract

The aim of this study was to evaluate factors related to the restoration of endodontically treated teeth (ETT) using research reporting guidelines and evaluating the use of the latter in the literature. Thus, this thesis was divided into six chapters with the following aims: in chapter 1, a survey with dentists of the city of Pelotas evaluating their preferences for materials to restore ETT was performed. In chapter 2, we performed a literature review discussing the current concepts on the restoration of endodontically treated teeth based on two factors: endodontic treatment and intra-radicular posts. In chapter 3, a systematic review of randomized controlled trials evaluated how selected factors influence the clinical performance of ETT restored with the combination of intra-radicular posts and single crowns. In chapter 4, a randomized controlled trial compared the survival of glass fiber posts and cast metal posts used to restore ETT without remaining coronal walls with up to 6 years of follow-up. In chapter 5, a literature review presents the main initiatives and research reporting guidelines as EQUATOR Network, CONSORT and PRISMA. In chapter 6, a survey with editors of dental journals registered on the 2013 Journal Citation Reports list (n=81) was conducted. In general, cast metal posts, glass fiber posts and resin cement were the most commonly selected materials by dentists and there was a significant association between the level of training of dentists and the type of post used. The preservation of remaining coronal walls is one of the most important factors that influence the longevity of ETT restored with intra-radicular posts. As for endodontic techniques, the use of conservative procedures that do not cause serious structural damages seems to be the best option for root canal preparation. Considering ETT with remaining coronal walls the use of metallic or non-metallic posts may be indicated. The systematic review suggests that the use of metallic and non-metallic posts is indicated in cases of absence of remaining coronal structure, although the generated the level of evidence was low. However, the results of the randomized controlled trial did not show difference between posts, while longer time of follow-up is required. Considering the use of reporting guidelines, their use is suboptimal and a better understanding of initiatives available in the literature is necessary for the development of oral health research