Estudo clínico e radiográfico do formocresol de Buckley a 1/5 e do cimento Portland utilizados para pulpotomias em dentes decíduos humanos
Clinical and radiographic study on 1/5 dilution of Buckley’s formocresol and Portland cement used for pulpotomies of human primary teeth
Fornetti, Ana Paula Camolese; Lourenço Neto, Natalino; Moretti, Ana Beatriz Silveira; Oliveira, T.M.; Sakai, Vivien Thiemy; Silva, Salete Moura Bonifácio; Machado, M.A.A.M.; Abdo, R.C.C.
Rev. odontol. UNESP, vol.38, n3, p.161-168, 2009
Resumo
O objetivo deste estudo foi comparar a eficácia clínica e radiográfica do formocresol de Buckley diluído a 1/5 e do cimento Portland como agentes capeadores pulpares em dentes decíduos humanos acometidos por cárie extensa, tratados pela técnica convencional de pulpotomia. Sessenta e oito primeiros molares inferiores em 52 crianças com idades entre 5 e 9 anos foram criteriosamente selecionados. De forma randômica, formaram-se dois grupos de 34 molares, cada qual sendo tratado com um dos agentes capeadores a serem comparados. Após a realização das pulpotomias, avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6 e 12 meses do pós-operatório. Nenhum sinal de falha clínica foi observado, para ambos os grupos, em todos os períodos avaliados. Diferença estatisticamente significativa entre os grupos foi observada apenas quando avaliada a coloração da coroa dentária e a obliteração do canal radicular, visto que todos os dentes tratados com o cimento Portland apresentaram discreta coloração acinzentada e estenose radicular. O cimento Portland foi tão efetivo quanto o formocresol como capeador pulpar em pulpotomias de dentes decíduos. Embora os resultados sejam encorajadores, estudos futuros e com acompanhamentos a longo prazo são necessários para se determinar a indicação clínica segura do cimento Portland.
Palavras-chave
Cimento Portland, dente decíduo, formocresol, pulpotomia
Abstract
This study aimed at comparing the clinical and radiographic effectiveness of 1:5 dilution of Buckley’s formocresol and Portland cement as pulp dressing agents in carious primary teeth treated by conventional pulpotomy. Sixty eight primary mandibular molars in 52 children between 5 and 9 years old were criteriously selected. Clinical and radiographic evaluations were recorded 3, 6 and 12-months postoperatively. No signs of clinical failure were observed at all follow-up appointments in both groups. Statistically significant difference between both groups was only observed when assessing tooth crown discoloration and pulp canal obliteration since all of the teeth treated with Portland cement presented dicrete grayish discoloration and root stenosis. Portland cement was equally effective as formocresol as pulp capping agent in pulpotomies of deciduous teeth. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement.
Keywords
Cimento Portland, dente decíduo, formocresol, pulpotomia.
References
1. Strange DM, Seale NS, Nunn ME, Strange M. Outcome of formocresol/ZOE sub-base pulpotomias utilizing alternative radiographic success criteria. Pediatr Dent. 2001;23:331-6.
2. Castro A. Current concepts in vital pulpotomies in primary teeth. J Mich Dent Assoc. 2005;87:26-8.
3. Fuks AB, Holan G, Davis JM, Eidelman E.Ferric sulfate versus dilute formocresol in pulpotomized primary molars: long-term follow-up. Pediatr Dent. 1997;19:327‑30.
4. Waterhouse PJ, Nunn JH, Whitworth JM. An investigation of the relative efficacy of Buckey’s formocresol and calcium hydroxide in primary molar vital pulp therapy. Br Dent J. 2000;188:32-6.
5. Dean JA, Mack RB, Fulkerson BT, Sanders BJ. Comparison of electrosurgical and formocresol pulpotomy procedures in children. Int J Paediatr Dent. 2002;12:177‑82.
6. Zarzar PA, Rosenblatt A, Takahashi CS, Takeuchi PL, Costa Júnior LA. Formocresol mutagenicity following primary tooth pulp therapy: an in vivo study. J Dent. 2003;31:479-85.
7. Massara MLA, Noronha JC, Souki BQ. Diniz APV, Navarro CF, Alencar MCB, et al. A utilização do hidróxido de cálcio em pulpotomias de dentes decíduos. RGO. 1996;44:300-4.
8. Burnett S, Walker J. Comparison of ferric sulfate, formocresol, and a combination of ferric sulfate/formocresol in primary tooth vital pulpotomies: a retrospective radiographic survey. J Dent Child. 2002;69:44-8.
9. Eidelman E, Holan G, Fuks AB. Mineral trioxide aggregate vs. formocresol in pulpotomized primary molars: a preliminary report. Pediatr Dent. 2001;23:15-8.
10. Agamy HA, Bakry NS, Mounir MM, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth. Pediatr Dent. 2004;26:302-9.
11. Aeinehchi M, Dadvand S, Fayazi S, Bayat-Movahed S.Randomized controlled trial of mineral trioxide aggregate and formocresol for pulpotomy in primary molar teeth. Int Endod J. 2007;40:261-7.
12. Funteas UR, Wallace JA, Fochtman EW. A comparative analysis of mineral trioxide aggregate end Portland cement. J Endod. 2002;28:259.
13. Camilleri J, Montesin FE, Di Silvio L, Pitt Ford TR. The chemical constitution and biocompatibility of accelerated Portland cement for endodontic use. Int Endod J. 2005;38:834-42.
14. Holan G, Fuks AB, Keltz N. Success rate of formocresol pulpotomy in primary molars restored with stainless steel crow vs amalgam. Pediatr Dent. 2002;24:212-6.
15. Huth KC, Paschos E, Hajek-Al-Khatar N, Hollweck R, Crispin A, Hickel R, et al. Effectiveness of 4 pulpotomy techniques – randomized controlled trial. J Dent Res. 2005;84:1144-8.
16. Ibricevic H, Al-Jame Q. Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up. J Clin Pediatr Dent. 2000;24:269-72.
17. Rivera N, Reyes E, Mazzaoui S, Morón A.Pulpal terapy for primary teeth: formocresol vs electrosurgey – a clinical study. J Dent Child. 2003;70:71-3.
18. Farooq NS, Coll JA, Kuwabara A, Shelton P. Success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth. Pediatr Dent. 2000;22:278-86.
19. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod. 1999;25:197-205.
20. Farsi N, Alamoudi N, Balto K, Mushayt A.Success of mineral trioxide aggregate in pulpotomized primary molars. J Clin Pediatr Dent. 2005;29:307-11.
21. Abdullah D, Ford TR, Papaioannou S, Nicholson J, McDonald F. An evaluation of accelerated Portland cement as a restorative material. Biomaterials. 2002;23:4001‑10.
22. Min KS, Kim HI, Park HJ, Pi SH, Hong CU, Kim EC. Human cells response to Portland cement in vitro. J Endod. 2007;33:163-6.
23. Holland R, de Souza V, Nery MJ, Faraco Júnior IM, Bernabé PF, Otoboni Filho JA, et al. Reaction of rat connective tissue to implanted dentin tube filled with mineral trioxide aggregate, Portland cement or calcium hydroxide. Braz Dent J. 2001;12:3-8.
24. Menezes RS. Microscopic analysis of dog dental pulp after pulpotomy and pulp protection with mineral trioxide aggregate and white Portland cement. J Appl Oral Sci. 2004;12:104-7.
25. Duarte MAH, Weckwerth PH, Kuga MC, Weckwerth ACV. Avaliação da contaminação do MTA Ângelus e do cimento Portland. JBC: J Bras Clin Odontol Int 2002;6(32):155-7.
26. Islam I, Chng HK, Yap AUJ. Comparison of the physical and mechanical properties of MTA and Portland cement. J Endod 2006;32(3):193-7.
27. de Morais CA, Bernardineli N, Garcia RB, Duarte MA, Guerisoli DM. Evaluation of tissue response to MTA and Portland cement with iodoform. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:417-21.
28. De Deus G, Coutinho Filho T. The use of white Portland cement as an apical plug in a tooth with and wide-open apex: a case report. Int Endod J. 2007;40:653-60.
29. Saidon J, He J, Zhu Q, Safavi K, Spångberg LS.Cell and tissue reactions to mineral trioxide aggregate and Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:483-9.
30. Moretti AB, Sakai VT, Oliveira TM, Fornetti AP, Santos CF, Machado MA, et al. Effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth. Int Endod J. 2008;41:547-55.