Estudo transversal com 408 profissionais: uma reflexão sobre realidade clínica e ensino em endodontia.

Abstract

INTRODUCTION: Endodontic treatment aims to preserve the periapex in vital teeth and reduce the microbial load in contaminated canals, utilizing extensive scientific evidence and technologies for its execution. However, heterogeneity is noted in global clinical practices, influenced by the level of specialization, experience, individual preferences, socioeconomic regional factors, and eventual knowledge gaps. The present study aimed to identify the clinical practices of 408 professionals performing endodontic treatments, correlating them with the level of training and guidelines for decision-making in endodontics. METHODS: This is a cross-sectional study conducted through a structured questionnaire answered by 408 dental surgeons from all Brazilian states regarding professional training, working length determination, instrumentation preferences, apical preparation diameter, and activation of auxiliary chemical substances. Data were statistically analyzed using Chi-square (X2) and Fisher’s Exact tests (P < 0.01). RESULTS: Enlargement greater than #30 is the majority choice of professionals regardless of kinematics. Reciprocating kinematics was associated with apical enlargement equal to or less than #25 in vital pulps for (27.3%) of the sample. Manual and mechanized techniques predominate among professionals with 10 years or more of experience (40.9%). A total of 191 (46.8%) professionals use both mechanized kinematics (rotary and reciprocating). Furthermore, 377 (92.4%) professionals perform irrigation solution activation, with a predominance among endodontic specialists (81.7%). Concurrently, (72.3%) use heat-treated instruments. However, even when employing heat-treated instruments, (73.5%) of respondents reduce the final preparation diameter in curved canals. CONCLUSION: The data reveal significant variability in the clinical conduct adopted by professionals, demonstrating the importance of training in clinical decision-making. The need to strengthen academic and professional training is emphasized, aligning clinical training with scientific evidence as well as establishing basic guidelines that ensure the quality of endodontic treatments while respecting their specific peculiarities.