Proteção pulpar direta com agregado trióxido mineral (MTA) em molar
decíduo com agenesia do sucessor permanente

Fidalgo, Tatiana Kelly da Silva; Risso, Patrícia de Andrade; Kuchler, Érica Calvano; Costa, Marcelo de Castro

Original Article

Proteção pulpar direta com agregado trióxido mineral (MTA) em molar decíduo com agenesia do sucessor permanente

Direct pulp protection with mineral trioxide aggregate (MTA) in a primary molar with successor permanent agenesis

Fidalgo, Tatiana Kelly da Silva; Risso, Patrícia de Andrade; Kuchler, Érica Calvano; Costa, Marcelo de Castro

Rev. odontol. UNESP, vol.38, n6, p.383-387, 2009

PDF

Downloads: 13

Resumo

A manutenção do elemento decíduo na arcada tem fundamental importância no estabelecimento de uma oclusão normal, principalmente em casos de agenesia dental. A proteção pulpar direta é um tratamento conservador que visa à manutenção da vitalidade pulpar e possibilita a permanência do elemento dental na arcada. Um material recentemente utilizado é o Agregado Trióxido Mineral, devido às suas propriedades favoráveis, como atividade antimicrobiana e alta biocompatibilidade. Desta forma, o presente trabalho objetivou relatar um caso clínico de proteção pulpar direta com Agregado Trióxido Mineral em um molar decíduo com agenesia do sucessor permanente. Após o procedimento de proteção pulpar direta, as respostas teciduais foram acompanhadas clínica e radiograficamente durante dois anos e dois meses. Não foi observada a formação de tecido dentário, devido à avançada idade dentária. Entretanto, o Agregado Trióxido Mineral funcionou como uma barreira física capaz de vedar o tecido pulpar, mantendo-se a vitalidade pulpar, com ausência de sintomatologia dolorosa; demonstrou-se, assim, ser um material eficiente para o tratamento conservador pulpar direto de dentes decíduos, mesmo com idade dental avançada e agenesia do elemento sucessor.

Palavras-chave

Capeamento da polpa dentária, dente primário, anodontia

Abstract

The preservation of primary teeth in arch has fundamental importance on establishing of normal occlusion, mainly in cases of teeth agenesis. Direct pulp protection is a conservator treatment which main objective is the maintenance of pulp vitality and teeth function in arch. Mineral Trioxide Aggregate is a material used due to favorable properties as antimicrobial activity and high biocompatibility. Therefore, the objective of the present work was to relate a case report of direct pulp protection with Mineral Trioxide Aggregate in a primary molar with successor permanent agenesis. After direct pulp protection procedures, tissue responses were clinically and radiographically assessed during two years and two months. It was not observed dental tissue formation, probably due to advanced dental age. Mineral Trioxide Aggregate act as physical barrier, isolating pulp tissue, maintaining teeth vitality and absence of pain, thus demonstrating efficiency, even in teeth with advanced age mainly in cases of tooth agenesis.

Keywords

Dental pulp capping, tooth deciduous, anodontia.

References

1. Dammaschke T. The history of direct pulp capping. J Hist Dent. 2008;56:9-23.

2. Mathisen B. Direct pulp capping: an overview. Dent Stud. 1980;58:44-7,52.

3. Guideline on pulp therapy for primary and young permanent teeth. Pediatr Dent. 2008;30:170-4.

4. Faraco IM Jr, Holland R. Response of the pulp of dogs to capping with mineral trioxide aggregate or a calcium hydroxide cement. Dent Traumatol. 2001;17:163-6.

5. Baume LJ, Holz J. Long term clinical assessment of direct pulp capping. Int Dent J. 1981;31:251-60.

6. Fuks AB. Current concepts in vital primary pulp therapy. Eur J Paediatr Dent. 2002;3:115-20.

7. Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP. Using mineral trioxide aggregate as a pulpcapping material. J Am Dent Assoc. 1996;127:1491-4.

8. Maroto M, Barberia E, Vera V, Garcia-Godoy F. Mineral trioxide aggregate as pulp dressing agent in pulpotomy treatment of primary molars: 42-month clinical study. Am J Dent. 2007;20:283-6.

9. Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod. 1995;21:349-53.

10. Min KS, Park HJ, Lee SK, Park SH, Hong CU, Kim HW, et al. Effect of mineral trioxide aggregate on dentin bridge formation and expression of dentin sialoprotein and heme oxygenase-1 in human dental pulp. J Endod. 2008;34:666-70.

11. Mitchell PJ, Pitt Ford TR, Torabinejad M, McDonald F. Osteoblast biocompatibility of mineral trioxide aggregate. Biomaterials. 1999;20:167-73.

12. Saidon J, He J, Zhu Q, Safavi K, Spangberg 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.

13. Sabri R. Management of over-retained mandibular deciduous second molars with and without permanent successors. World J Orthod. 2008;9:209-20.

14. Ribeiro DA, Sugui MM, Matsumoto MA, Duarte MA, Marques ME, Salvadori DM. Genotoxicity and cytotoxicity of mineral trioxide aggregate and regular and white Portland cements on Chinese hamster ovary (CHO) cells in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:258-61.

15. Santos AD, Moraes JC, Araujo EB, Yukimitu K, Valerio Filho WV. Physico-chemical properties of MTA and a novel experimental cement. Int Endod J. 2005;38:443-7.

16. Torabinejad M, Hong CU, Pitt Ford TR, Kettering JD. Cytotoxicity of four root end filling materials. J Endod. 1995;21:489-92.

17. Duarte MA, Demarchi AC, Yamashita JC, Kuga MC, Fraga Sde C. pH and calcium ion release of 2 root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:345-7.

18. Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31:97-100.

19. Andelin WE, Shabahang S, Wright K, Torabinejad M. Identification of hard tissue after experimental pulp capping using dentin sialoprotein (DSP) as a marker. J Endod. 2003;29:646-50.

20. Faraco Junior IM, Holland R. Histomorphological response of dogs’ dental pulp capped with white mineral trioxide aggregate. Braz Dent J. 2004;15:104-8.

21. Tziafas D, Pantelidou O, Alvanou A, Belibasakis G, Papadimitriou S. The dentinogenic effect of mineral trioxide aggregate (MTA) in short-term capping experiments. Int Endod J. 2002;35:245-54.

22. Nair PN, Duncan HF, Pitt Ford TR, Luder HU. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J. 2008;41:128-50.

23. Tecles O, Laurent P, Aubut V, About I. Human tooth culture: a study model for reparative dentinogenesis and direct pulp capping materials biocompatibility. J Biomed Mater Res B Appl Biomater. 2008;85:180-7.

24. Koshy S, Love RM. Endodontic treatment in the primary dentition. Aust Endod J. 2004;30:59-68.

25. Fidalgo TKS, Barcelos R, Petrópolis DB, Azevedo BR, Primo LG, Silva Filho FC. Citotoxidade de diferentes concentrações de hipoclorito de sódio sobre osteoblastos humanos. RGO (Porto Alegre). 2009;57:317-21.

26. Bodem O, Blumenshine S, Zeh D, Koch MJ. Direct pulp capping with mineral trioxide aggregate in a primary molar: a case report. Int J Paediatr Dent. 2004;14:376-9.

27. Koh ET, McDonald F, Pitt Ford TR, Torabinejad M. Cellular response to Mineral Trioxide Aggregate. J Endod. 1998;24:543-7.