USO DE SOLUÇÕES IRRIGADORAS NA PULPECTOMIA DE DENTES DECÍDUOS: REVISÃO DE LITERATURA
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Publicado:
Jan 7, 2022
Palavras-chave:
pulpectomia, dente decíduo, irrigantes do canal radicular
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Resumo
A limpeza dos canais radiculares se apresenta como uma etapa crucial para o sucesso do tratamento endodôntico. Por essa razão, a busca por soluções irrigadoras eficazes na terapia endodôntica de dentes decíduos é freqüente nas pesquisas e demonstra a necessidade de encontrar substâncias com menor toxicidade e maior eficiência. Sendo assim, o objetivo do presente estudo é analisar as diferentes soluções e protocolos de irrigação no tratamento endodôntico de dentes decíduos, a fim de construir uma conduta clínica. Para isso, foi realizada uma busca na literatura nas bases de dados PubMed/MEDLINE, Cochrane Library, SCIELO, Portal de Periódicos CAPES e BVS utilizando a combinação dos termos “deciduous tooth”, “root canal irrigants”, “pulpectomy” e seus derivados, associados entre si pelo operador booleano “AND” e adaptados para cada base de dados. As buscas foram realizadas no período de Julho à Agosto de 2020. Foi encontrado o total de 192 resultados. Após uma leitura crítica, foram selecionados 8 estudos. A revisão incluiu estudos que abordassem as soluções irrigantes mais usuais: hipoclorito de sódio, digluconato de clorexidina, ácido cítrico e ácido etilenodiaminotetracético (EDTA) na terapia endodôntica de dentes decíduos. O EDTA e digluconato de clorexidina apresentam baixa toxicidade e o hipoclorito de sódio 1% combinado com ácido cítrico 6% apresentam a combinação mais próspera. A associação das duas substâncias mostrou ser mais eficiente na limpeza dos canais radiculares e remoção da smear layer. Porém, mais estudos são necessários, principalmente clínicos, para confirmação do melhor protocolo de irrigação para o tratamento endodôntico de dentes decíduos.
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Como Citar
Kolling Marquezan, F., Dalcin Manfio, J. C., & Kolling Marquezan, P. (2022). USO DE SOLUÇÕES IRRIGADORAS NA PULPECTOMIA DE DENTES DECÍDUOS: REVISÃO DE LITERATURA. Revista Naval De Odontologia, 48(I). Recuperado de http://portaldeperiodicos.marinha.mil.br/index.php/odontoclinica/article/view/1939
Seção
Revisões de Literatura
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Referências
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3. Tewari N, Bansal K, Mathur VP. Dental Trauma in Children: A Quick Overview on Management. Indian J Pediatr. 2019 Nov;86(11):1043-47.
4. Leonardo M, Leonardo R. Tratamento de canais radiculares: avanços tecnológicos de uma endodontia minimamente invasiva e reparadora. 3. ed. São Paulo: Artes Médicas, 2012.
5. da Silva LA, Nelson-Filho P, Faria G, de Souza-Gugelmin MC, Ito IY. Bacterial profile in primary teeth with necrotic pulp and periapical lesions. Braz Dent J. 2006;17(2):144-8.
6. Kaur R. Review article irrigating solutions in Pediatric Dentistry: literature review and update. J AdvMed Dental Scienc, Haryana. 2014;2(2):104-115.
7. Ito IY, Junior FM, Paula-Silva FW, Da Silva LA, Leonardo MR, Nelson-Filho P. Microbial culture and checkerboard DNA-DNA hybridization assessment of bacteria in root canals of primary teeth pre- and post-endodontic therapy with a calcium hydroxide/chlorhexidine paste. Int J Paediatr Dent. 2011 Sep;21(5):353-60.
8. Alacam A. The effect of various irrigants on the adaptation of paste filling in primary teeth. J Clin Pediatr Dent. 1992 Summer;16(4):243-6.
9. Barcelos R, Tannure PN, Gleiser R, Luiz RR, Primo LG. The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized, and controlled clinical trial evaluation. Int J Paediatr Dent. 2012 Sep;22(5):369-81.
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11. Valdez-Gonzalez C, Mendez-Gonzalez V, Torre-Delgadillo G, Flores-Reyes H, Gaitan-Fonseca C, Pozos-Guillen AJ. Effectiveness of oxidative potential water as an irrigant in pulpectomized primary teeth. J Clin Pediatr Dent. 2012 Fall;37(1):31-5.
12. Jolly M, Singh N, Rathore M, Tandon S, Banerjee M. Propolis and commonly used intracanal irrigants: comparative evaluation of antimicrobial potential. J Clin Pediatr Dent. 2013 Spring;37(3):243-9.
13. Tulsani SG, Chikkanarasaiah N, Bethur S. An in vivo comparison of antimicrobial efficacy of sodium hypochlorite and Biopure MTAD™ against enterococcus faecalis in primary teeth: A qPCR study. J Clin Pediatr Dent. 2014 Fall;39(1):30-4.
14. Ruiz-Esparza CL, Garrocho-Rangel A, Gonzalez-Amaro AM, Flores-Reyes H, Pozos-Guillen AJ. Reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigant in pulpectomized primary teeth: a preliminary report. J Clin Pediatr Dent. 2011 Spring;35(3):265-70.
15. Barcelos R.Efetividade de substâncias químicas auxiliares na desinfecção e
saneamento de canais radiculares de dentes decíduos. In: Reunião Anual da SBPqO, 20, 2003, Águas de Lindoia. Pesquisa Odontológica Brasileira. Anais. São Paulo: SBPqO, 2003.7:229
16. Botton G, Pires CW, Cadoná FC, Machado AK, Azzolin VF, Cruz IB, Sagrillo MR, Praetzel JR. Toxicity of irrigating solutions and pharmacological associations used in pulpectomy of primary teeth. Int Endod J. 2016 Aug;49(8):746-54.
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18. Hargreaves K., Cohen S..Caminhos da Polpa. 11. ed. Rio de Janeiro: Elsevier, 2017
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20. Michelotto M. Clorexidina na terapia endodôntica, Revista Sul-Brasileira de Odontologia, Brasil, 2008;5(1):77-89.
21. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
22. Darda S, Madria K, Jamenis R, Heda A, Khanna A, Sardar L. An in-vitro evaluation of effect of EDTAC on root dentin with respect to time. J Int Oral Health. 2014 Apr;6(2):22-7.
23. Güzel C, Uzunoglu E, Dogan Buzoglu H. Effect of Low-surface Tension EDTA Solutions on the Bond Strength of Resin-based Sealer to Young and Old Root Canal Dentin. J Endod. 2018 Mar;44(3):485-488.
24. Plotino G. New Technologies to Improve Root Canal Disinfection. Bra Dent J. 2016:27(1):3-8.
25. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
26. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod. 2010 Jan;36(1):105-9.
27. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech. 2018 Mar;81(3):275-282.
28. Gandolfi MG, Taddei P, Pondrelli A, Zamparini F, Prati C, Spagnuolo G. Demineralization, Collagen Modification and Remineralization Degree of Human Dentin after EDTA and Citric Acid Treatments. Materials (Basel). 2018 Dec 21;12(1):25.
29. Turk T, Kaval ME, Şen BH. Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study. BMC Oral Health. 2015 Sep 3;15:104.
30. Arguello, K. Visión Actualizada de la Irrigación em Endodocia: Más Allá del NaOCl de Sódio. El Odont.Inv, Venezu ela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014..
32. Götze Gda R, Cunha CB, Primo LS, Maia LC. Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars. Braz Oral Res. 2005 Oct-Dec;19(4):261-6. doi: 10.1590/s1806-83242005000400005. Epub 2006 Feb 14.
33. Hegde RJ, Bapna K. Comparison of removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid and citric acid in primary teeth: A scanning electron microscopic study. Contemp Clin Dent. 2016 Apr-Jun;7(2):216-20.
34. Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand. 2020 Jul;78(5):321-326.
2. Raslan N, Wetzel WE. Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation. Dent Traumatol. 2006 Jun;22(3):145-53.
3. Tewari N, Bansal K, Mathur VP. Dental Trauma in Children: A Quick Overview on Management. Indian J Pediatr. 2019 Nov;86(11):1043-47.
4. Leonardo M, Leonardo R. Tratamento de canais radiculares: avanços tecnológicos de uma endodontia minimamente invasiva e reparadora. 3. ed. São Paulo: Artes Médicas, 2012.
5. da Silva LA, Nelson-Filho P, Faria G, de Souza-Gugelmin MC, Ito IY. Bacterial profile in primary teeth with necrotic pulp and periapical lesions. Braz Dent J. 2006;17(2):144-8.
6. Kaur R. Review article irrigating solutions in Pediatric Dentistry: literature review and update. J AdvMed Dental Scienc, Haryana. 2014;2(2):104-115.
7. Ito IY, Junior FM, Paula-Silva FW, Da Silva LA, Leonardo MR, Nelson-Filho P. Microbial culture and checkerboard DNA-DNA hybridization assessment of bacteria in root canals of primary teeth pre- and post-endodontic therapy with a calcium hydroxide/chlorhexidine paste. Int J Paediatr Dent. 2011 Sep;21(5):353-60.
8. Alacam A. The effect of various irrigants on the adaptation of paste filling in primary teeth. J Clin Pediatr Dent. 1992 Summer;16(4):243-6.
9. Barcelos R, Tannure PN, Gleiser R, Luiz RR, Primo LG. The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized, and controlled clinical trial evaluation. Int J Paediatr Dent. 2012 Sep;22(5):369-81.
10. Pintor AV, Dos Santos MR, Ferreira DM, Barcelos R, Primo LG, Maia LC. Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review. J Clin Pediatr Dent. 2016 Winter;40(1):1-7.
11. Valdez-Gonzalez C, Mendez-Gonzalez V, Torre-Delgadillo G, Flores-Reyes H, Gaitan-Fonseca C, Pozos-Guillen AJ. Effectiveness of oxidative potential water as an irrigant in pulpectomized primary teeth. J Clin Pediatr Dent. 2012 Fall;37(1):31-5.
12. Jolly M, Singh N, Rathore M, Tandon S, Banerjee M. Propolis and commonly used intracanal irrigants: comparative evaluation of antimicrobial potential. J Clin Pediatr Dent. 2013 Spring;37(3):243-9.
13. Tulsani SG, Chikkanarasaiah N, Bethur S. An in vivo comparison of antimicrobial efficacy of sodium hypochlorite and Biopure MTAD™ against enterococcus faecalis in primary teeth: A qPCR study. J Clin Pediatr Dent. 2014 Fall;39(1):30-4.
14. Ruiz-Esparza CL, Garrocho-Rangel A, Gonzalez-Amaro AM, Flores-Reyes H, Pozos-Guillen AJ. Reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigant in pulpectomized primary teeth: a preliminary report. J Clin Pediatr Dent. 2011 Spring;35(3):265-70.
15. Barcelos R.Efetividade de substâncias químicas auxiliares na desinfecção e
saneamento de canais radiculares de dentes decíduos. In: Reunião Anual da SBPqO, 20, 2003, Águas de Lindoia. Pesquisa Odontológica Brasileira. Anais. São Paulo: SBPqO, 2003.7:229
16. Botton G, Pires CW, Cadoná FC, Machado AK, Azzolin VF, Cruz IB, Sagrillo MR, Praetzel JR. Toxicity of irrigating solutions and pharmacological associations used in pulpectomy of primary teeth. Int Endod J. 2016 Aug;49(8):746-54.
17. Lopes, H., Siqueira, J., Endodontia: Biologia e Técnica. 2ª. ed. Rio de Janeiro: Ed. Med Guanabara Koogan S. A, 2004, p. 245.
18. Hargreaves K., Cohen S..Caminhos da Polpa. 11. ed. Rio de Janeiro: Elsevier, 2017
19. Estrela C, Estrela CR, Decurcio DA, Hollanda AC, Silva JA. Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Int Endod J. 2007 Feb;40(2):85-93.
20. Michelotto M. Clorexidina na terapia endodôntica, Revista Sul-Brasileira de Odontologia, Brasil, 2008;5(1):77-89.
21. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
22. Darda S, Madria K, Jamenis R, Heda A, Khanna A, Sardar L. An in-vitro evaluation of effect of EDTAC on root dentin with respect to time. J Int Oral Health. 2014 Apr;6(2):22-7.
23. Güzel C, Uzunoglu E, Dogan Buzoglu H. Effect of Low-surface Tension EDTA Solutions on the Bond Strength of Resin-based Sealer to Young and Old Root Canal Dentin. J Endod. 2018 Mar;44(3):485-488.
24. Plotino G. New Technologies to Improve Root Canal Disinfection. Bra Dent J. 2016:27(1):3-8.
25. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
26. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod. 2010 Jan;36(1):105-9.
27. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech. 2018 Mar;81(3):275-282.
28. Gandolfi MG, Taddei P, Pondrelli A, Zamparini F, Prati C, Spagnuolo G. Demineralization, Collagen Modification and Remineralization Degree of Human Dentin after EDTA and Citric Acid Treatments. Materials (Basel). 2018 Dec 21;12(1):25.
29. Turk T, Kaval ME, Şen BH. Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study. BMC Oral Health. 2015 Sep 3;15:104.
30. Arguello, K. Visión Actualizada de la Irrigación em Endodocia: Más Allá del NaOCl de Sódio. El Odont.Inv, Venezu ela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014..
32. Götze Gda R, Cunha CB, Primo LS, Maia LC. Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars. Braz Oral Res. 2005 Oct-Dec;19(4):261-6. doi: 10.1590/s1806-83242005000400005. Epub 2006 Feb 14.
33. Hegde RJ, Bapna K. Comparison of removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid and citric acid in primary teeth: A scanning electron microscopic study. Contemp Clin Dent. 2016 Apr-Jun;7(2):216-20.
34. Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand. 2020 Jul;78(5):321-326.