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No intuito de avaliar novas possibilidades de instrumentacao radicular em dentes deciduos, o objetivo do presente estudo foi avaliar a performance de tres diferentes metodos, manual e mecanizados, utilizando tomografia computadorizada por feixe conico (TCFC). As tecnicas utilizadas foram manual (MAN), rotatoria com o sistema Protaper (ROT) e oscilatoria com o sistema EndoEZE (OSC). Para o segundo objetivo, as tecnicas foram testadas em dentes deciduos naturais e artificiais, para que tambem se pudesse avaliar a diferenca entre a performance dos metodos nesses dois tipos de dentes. Apos o acesso endodontico inicial, imagens padronizadas foram realizadas em aparelho de TCFC (sistema iCat), com cortes sagital, coronal e axial. Apos a instrumentacao dos dentes pelos diferentes metodos, novas imagens foram realizadas. Avaliacoes quantitativas foram feitas medindo-se nas imagens axiais dos canais radiculares, a espessura das paredes e area do canal, em tres diferentes regioes: tercos cervical, medio e apical. Tres desfechos foram considerados apos instrumentacao: desvio para a parede de risco, descentralizacao do canal e diferenca na area do canal antes e apos a instrumentacao. Os valores foram comparados com analise de variância e teste de Tukey, ou com testes nao parametricos. Nao houve diferenca no desvio entre os metodos para os dentes anteriores artificiais e naturais. Nos posteriores naturais, entretanto, a tecnica MAN apresentou maior desvio no terco cervical (p Com relacao as areas do canal, para os dentes anteriores, o metodo ROT e OSC apresentaram maior desgaste que o MAN nos tercos cervical e medio, mas no terco apical o OSC e o MAN foram semelhantes (p > 0,05). Para os posteriores, o metodo ROT apresentou um desgaste estatisticamente maior do que os demais apenas no terco apical (p In order to appraise new options of root canal instrumentation in primary teeth, the aim of the present study was to evaluate the performance of three different methods, manual and mechanical, using cone beam computed tomography (CBCT). The techniques tested were manual (MAN), rotatory with Protaper system (ROT) and oscillatory with EndoEZE system (OSC). For the second objective, the techniques were assessed in natural and artificial primary teeth, in order to evaluate the difference in the performance of the methods in these types of teeth. After initial endodontic access, standardized scans were obtained by CBTC (iCat system), with sagittal, coronal and axial planes. After the root canal instrumentation of teeth with different methods, new images were achieved. Quantitative evaluations were performed measuring the thickness of root canal wall and canal area in the axial images of root canals, at three different places: coronal, middle and apical thirds. Three outcomes were considered after the instrumentation: canal transportation towards the side of root resorption, centering ability and difference in canal area before and after the instrumentation. The values were compared using ANOVA and Tukey test, or with non-parametric tests. There were no differences among the methods used in both natural and artificial anterior teeth concerning the canal transportation. In the natural posterior teeth, however, the MAN technique showed greater canal transportation towards the size of root resorption in the coronal third (p 0.05). In posterior teeth, the ROT method showed statistically higher increase in canal area than the other methods only in the apical third. (AU) Qualitative analysis of the shaping patterns of each root canal instrumentation method were carried out and presented in graphics and images obtained with CBCT. After evaluating the images, the shaping pattern of all root canals showed a larger area in the coronal and smaller in apical third. The MAN method tended to preserve the baseline anatomy of the root canal in all areas. The ROT method, on the other hand, presented more significant changes in the anatomical shaping in all thirds, and the OSC method showed higher increase in canal area in the coronal and middle thirds, compared to the apical third. The artificial teeth are very similar to natural teeth in their anatomical shape and radiopacity, but they yielded different results in several of the outcomes, which limits their use as substitute of natural teeth for research purpose. In conclusion, the MAN method presents good performance for root canal instrumentation in primary teeth, but the OSC system would be the best option to achieve the advantages of mechanical instrumentation. (AU)

Performance de diferentes métodos de instrumentação radicular em dentes decíduos humanos e artificiais avaliado pela tomografia computadorizada por feixe cônico