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Cimento bioativo e biocompatível como elemento único em pulpotomiade dentes decíduos: ensaio clínic

Fernanda Valadão MOYSÉS1 https://orcid.org/0000-0002-0709-5853

Daniela Francescato VEIGA1 https://orcid.org/0000-0002-8713-2940

Marcelo Junqueira PEREIRA2 https://orcid.org/0000-0002-6769-863X

Matheus Henrique Lopes DOMINGUETE2 https://orcid.org/0000-0003-2742-6848

Camila Alessandra PAZZINI2 https://orcid.org/0000-0002-1699-4682

Ana Carla Junqueira PEREIRA2 https://orcid.org/0000-0002-4585-3256

José Dias da SILVA NETO1 https://orcid.org/0000-0001-6166-0035


 

ABSTRACT

Objective: Pulpotomy in deciduous teeth maintains the integrity and health of deciduous teeth and supporting tissues until a permanent tooth has erupted. PBS HD CIMMO® cement was evaluated in deciduous teeth pulpotomies as base material and restoration. A randomized clinical trial was performed. Methods: This study was approved by the Ethics Committee of (Universidade Vale do Sapucaí) UNIVÁS with Certificate of Presentation for Ethical Consideration, protocol number is: 1.771.929. 60 deciduous molar teeth from 32 healthy children were selected. These teeth were divided into two groups: G1 with 30 teeth, in which the classictreatment with formocresol was used, and G2 with 30 teeth, in which PBS HD CIMMO® cement was used as base and simultaneous final restoration. The evaluation was performed 12 months after the intervention through clinical and radiographic exams. Fisher’s exact test was performed to correlate the clinical and radiographic aspects in both groups. Results: There was no significant difference (p= 0.090) in the clinical-radiographic evaluation. PBS HD CIMMO® cement is option to be used as a single element in pulpotomies of deciduous teeth. Conclusion: Longitudinal studies should be performed in order to demonstrate a significant association between these groups. The study was enrolled in clinical trials (clinical trials.gov) with registration NCT03200938. Indexing terms: Pediatric dentistry. Pulpotomy. Biocompatible materials.


 

RESUMO

Objetivos: A pulpotomia em dentes decíduos mantém a integridade e a saúde dos dentes decíduos e dos tecidos de suporte, até a erupção de um dente permanente. O cimento PBS HD CIMMO® foi avaliado em pulpotomias de dentes decíduos como material.

Universidade do Vale do Sapucaí, Mestrado profissional em Ciências Aplicadas à Saúde. Av. Prefeito Tuany Toledo, 470, Fátima I, 37554-210, Pouso Alegre, MG, Brasil. Correspondence to: JD SILVA NETO. E-mail: <jdendod@yahoo.com.br>.

2 Universidade Vale do Rio Verde, Faculdade de Odontologia. Três Corações, MG, Brasil.

How to cite this article Moysés FV, Veiga DF, Pereira MJ, Dominguete MHL, Pazzini CA, Pereira ACJ, et al. Bioactive and biocompatible cement as a single element in pulpotomy of deciduous teeth: a randomized clinical trials. RGO, Rev Gaúch Odontol. 2020;68:e20200028. http://dx.doi.org/10.1590/1981-863720200002820180081

de base e restauração. Um ensaio clínico randomizado foi realizado. Métodos: Este estudo foi aprovado pelo Comitê de Ética da Universidade Vale do Sapucaí, UNIVÁS, com Certificado de Apresentação para Consideração Ética, número do protocolo: 1.771.929.

Foram selecionados 60 dentes molares decíduos de 32 crianças saudáveis. Esses dentes foram divididos em dois grupos: G1 com 30 dentes, no qual foi utilizado o tratamento clássico com formocresol e G2 com 30 dentes, no qual o cimento PBS HD CIMMO® foi utilizado como base e restauração final simultânea. A avaliação foi realizada 12 meses após a intervenção através de exames clínicos e radiográficos. O teste exato de Fisher foi utilizado para correlacionar os aspectos clínicos e radiográficos nos dois grupos. Resultados: Não houve diferença significativa (p = 0,090) na avaliação clínico-radiográfica. O cimento PBS HD CIMMO® é uma opção para ser usado como um elemento único em pulpotomias de dentes decíduos. Conclusão: Estudos longitudinais devem ser realizados para demonstrar uma associação significativa entre esses grupos. O estudo foi inscrito em ensaios clínicos (Clinical Trials.gov) com o registro NCT03200938.

Termos de indexação: Odontopediatria. Pulpotomia. Materiais biocompatíveis.


 

INTRODUCTION

Pulpotomy in deciduous teeth consists of removal of the coronary pulp due to extensive carious process without evidence of root pathology. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposures. The carious exposure is resumed to be accompanied by severe inflammation, which makes the prognosis of treatment unpredictable. Biomaterials can be used especially in cases with carious pulp exposures [1]. The primary purpose of pulpotomy is to maintain the integrity and health of deciduous teeth and supporting tissues until a permanent tooth has erupted. In this technique, the remaining pulp is maintained with vitality and is free of any pathological

alterations [1-3]. Formocresol (FC), idealized by Buckley in 1904, is considered the gold standard product due to its bacteriostatic and fixative properties and is the agent most frequently used in pulpotomy [3]. However, FC is composed of formaldehyde, which has mutagenic, carcinogenic action and cresol, which is a caustic agent. Cements, such as zinc oxide and eugenol, are used due to the absence of a material with bio-compatible and

bioactive properties, which can be installed directly on the exposed wound on the entrance of the root canals [4]. The occurrence of internal resorption may be attributed to the use of zinc oxide and eugenol (ZOE) as a sub-base, since the eugenol is irritant and may cause a subclinical chronic inflammation. Moreover, other factors are related to this alteration, such as inadequate bleeding control and clot formation, as well as improper restorations with failed sealing, allowing bacterial infiltration and pulp inflammation [5]. The objective of this study was to use in pulpotomies of deciduous teeth, cement not yet used for this indication. The advent of biological cements signaled a new era in odontology. These cements are biocompatible and bioactive alternatives for use in procedures in which a conventional technique is limited [6,7]. The biological cements exclude the use of drugs, such as formocresol, summarizing the technique in the removal of the coronary pulp, hemostasis and cement installation. MTA mineral trioxide aggregate), Biodentine TM (Septodont, St. Maur des Fosses) and PBS HD CIMMO® cement are several examples of bioactive cements [6-8]. Recent studies determined the development of biological cement with the same base as MTA and Biodentine, but with additives (natural elements responsible for the increase of cement resistance) and without

radiopacifier, an element that interferes with the resistance of cement, which is an important requirement, owing to the masticatory forces. This cement is the PBS HD CIMMO® [6,7,9-11]. The physical and biological properties of this cement justify its use in pulpotomies of deciduous teeth.




 

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