Direct pulp protection with bioceramic. A 15-year-old male patient came to the clinic reporting typical symptoms of reversible pulp inflammation in the lower left region, and pain in the cold with a rapid decline. Clinical examination revealed extensive caries and a slightly exacerbated vitality test on tooth 37. Radiographic examination showed incomplete root formation compatible with Nolla stage 9. Conservative treatment was then chosen with curettage of the decayed dentin, decontamination of the pulp chamber with hypochlorite, placement of Bio C Repair cement (Angelus) and subsequent sealing with dentin adhesive and flow resin.
The 20-month follow-up shows continued rhizogenesis and reparative dentin formation.
The patient was oriented and will be followed clinically and radiographically while waiting for the end of the root formation.
Direct pulpal capping with MTA:
Endodontic therapies in deciduous teeth aim to maintain these elements with the purpose of maintaining space in the dental arch. Among the conservative endodontic therapies, direct pulpal protection stands out. This treatment is a procedure in which an exposed dental pulp is covered with a drug or material that protects it from further injury, allowing its repair. This procedure is performed when there is accidental microexposure of the pulp, according to certain criteria, such as: absence of spontaneous painful symptomatology, absence of periapical lesion, young dental age, and physiological rhizolysis of less than one third of the root. Currently, direct pulp protection is a proven effective procedure.
In a study with dog teeth, Faraco Jr, Holland demonstrated, through histological analysis, the formation of a dentin bridge in 84.6% of the dental elements after direct pulp protection. In this context, the material used in contact with the pulp remnant is relevant, since it is necessary to maintain the integrity of the root pulp. Among these materials, the iodoformed pastes, calcium hydroxide pastes and Mineral Trioxide Aggregate (MTA) stand out.
In: Fidalgo et al. Rev Odontol UNESP, Araraquara, v. 38, n. 6, p. 383-87, nov./dez. 2009
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