Uso de Soluções Irrigadoras na Pulpectomia de Dentes Decíduos: Revisão de Literatura Use of Irrigating Solutions in Pulpectomy of Deciduous Teeth: Literature Review
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Publicado:
Mai 12, 2021
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 frequente 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 na 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
Cristina Dalcin Manfio, J., Kolling Marquezan, P., & Kolling Marquezan, F. (2021). Uso de Soluções Irrigadoras na Pulpectomia de Dentes Decíduos: Revisão de Literatura. Revista Naval De Odontologia, 48(I), 33-40. https://doi.org/10.29327/25149.48.1-4
Seção
Revisões de Literatura
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Referências
1. Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi
M, Lopez A, et al. Global burden of oral conditions in 1990-
2010: a systematic analysis. J Dent Res. 2013 Jul;92(7):592-7.
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 DNADNA
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, et al. 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, SilvaJA. 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 Lowsurface
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, et al. 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, Venezuela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006
May;32(5):389-98.
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.
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 microleakagmicroleakage in primary teeth. Acta
Odontol Scand. 2020 Jul;78(5):321-326.
M, Lopez A, et al. Global burden of oral conditions in 1990-
2010: a systematic analysis. J Dent Res. 2013 Jul;92(7):592-7.
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 DNADNA
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, et al. 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, SilvaJA. 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 Lowsurface
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, et al. 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, Venezuela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006
May;32(5):389-98.
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.
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 microleakagmicroleakage in primary teeth. Acta
Odontol Scand. 2020 Jul;78(5):321-326.