Pronóstico de la endodoncia convencional después de negociar los conductos con instrumento separado. Revisión sistemática

Abstract

Introduction: In the clinical practice of endodontics, separation of intracanal instruments can occur, at any stage of the procedure, instruments such as Gates Glidden burs, Nickel Titanium files, stainless steel files, ultrasonic tips, among others. They can be separated by cyclic or torsional fatigue or by a combination of both; when there are repeated compressive and tensile forces acting on the external part of the file rotating inside a curved canal, or when the tip of the file gets stuck, but the file shaft is still moved by the motor. Methodology: The study is a systematic review. The databases established for the search were: Pubmed, Cochrane, Scopus, Lilacs, Embase. Through this search, 501 articles were obtained, published between 1999 and 2019, of which 484 were obtained due to duplication of some of them. A total of 17 were selected to read the summary and after applying the selection criteria, 7 studies were obtained and the analysis of all variables was performed on the reported sample of 401 teeth. For the analysis of the risk of bias, a tool was developed based on the Prisma guide and the CARE and Faggion guidelines. Results: Of the seven publications, 4 were case series, 1 in vitro study, 1 descriptive cross-sectional study and 1 case report. The most frequent effectiveness evaluation methods were radiographic in 5 publications. The most commonly reported separate instruments were rotary files in 6 studies and the follow-up time was between 3 and 5 years. Conclusion: In the seven articles evaluated, the intracanal separation of the instruments presents a risk between low and medium and the prognosis of the teeth is between good and regular.