EFICÁCIA DA REVASCULARIZAÇÃO NA FORMAÇÃO DO ÁPICE RADICULAR EM PACIENTES COM RIZOGÊNESE INCOMPLETA: UMA REVISÃO INTEGRATIVA
DOI:
https://doi.org/10.24980/ucsb.v4i7.3530Palavras-chave:
Ápice dentário, Endodontia, Necrose pulparResumo
Objetivos: Verificar a eficácia da revascularização para induzir a continuidade de formação do ápice radicular em pacientes com rizogênese incompleta. Metodologia: A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, Embase, Web of Science e LILACS, sendo selecionados quatro artigos publicados entre 2011 e 2021. Resultados: Um total de 27 pacientes diagnosticados com necrose pulpar foi incluído, de ambos os sexos. Os testes de percussão, térmico e elétrico no exame clínico foram realizados em 4 pacientes. Todos os pacientes fizeram radiografia periapical para análise inicial. O tratamento endodôntico foi realizado com indução do sangramento apical do canal radicular para revascularização em todos os estudos. No acompanhamento de até 4 anos, observou-se, radiograficamente, aumento do comprimento e espessura radicular, diminuição e posterior desaparecimento da radioluscência periapical, estreitamento do ápice radicular, desenvolvimento radicular e redução da lesão periapical. Conclusão: A revascularização permite que, mesmo após o estímulo para indução de sangramento, a região periapical continue a formação radicular por mais tempo quando comparada a outros materiais endodônticos.
THE EFFECTIVENESS OF REVASCULARIZATION ON ROOT APEX FORMATION IN PATIENTS WITH IMMATURE PERMANENT TEETH: AN INTEGRATIVE REVIEW
ABSTRACT
Objectives: To verify the effectiveness of revascularization to induce further root apex formation in patients with immature permanent teeth. Method: A searching strategy was performed at PubMed, Embase, Web of Science, and LILACS electronic database, four articles issued between 2011 and 2021 were screened. Results: A total of 27 patients diagnosed with pulp necrosis were included, both genders. Percussion, electric, and thermal pulp testing were performed for clinical examination in those 4 patients. All the patients had a periapical x-ray taken for initial analysis. The endodontic treatment was performed with the apex-induced bleeding into the root canal for the revascularization in all the studies. At a 4-year follow-up it was observed, radiographically, an increase in root length and thickness, and afterward the periapical radiolucency disappearance, the root apex narrowing, root growing, and the periapical lesion reduction. Conclusion: Revascularization enables, even after the stimulus for bleeding induction, the periapical region to further continue the root formation when compared to other endodontic materials.
Descriptors: Endodontics. Pulp Necrosis. Tooth Apex.
Referências
Ferreira R, Cunha SR, Bueno CES, Dotto SD. Endodontic treatment in nonvital young permanent teeth with incomplete root formation – Apexification. Rev Facul Odontol Passo Fundo. 2002;7(1):29-32. Disponível em: http://seer.upf.br/index.php/rfo/article/view/1561/1037
Leonardo MR, Silva LAB. Curativo de Demora - Medicação Tópica entre Sessões. In: Endodontia: Tratamento de Canais Radiculares - Princípios técnicos e biológicos. São Paulo - SP: Editora Artes Médicas Ltda. 2005; p. 977-1048.
CabralCSF, GenizelliLO, Cruz RGZ. Treatment of immature permanent teeth with regenerative procedures or apicification: a systematic literature review. Rev Bras Odontol. 2016;73(4):336-339. Disponível em: http://revodonto.bvsalud.org/pdf/rbo/v73n4/a15v73n4.pdf
Annamalai S, Mungara J. Efficacy of Mineral Trioxide Aggregate as an Apical Plug in Non-Vital Young Permanent Teeth: Preliminary Results. J Clin Pediatr Dent. 2010;35(2):149-155. Disponível em: https://doi.org/10.17796/jcpd.35.2.9061h7g718834017
Pace R, Giuliani V, Pini PL, Bacetti T, Pagavino G. Apical plug technique using mineral trioxide aggregate: results from a case series. Int Endod J, Oxford. 2007;40:478-484, 2007. Disponível em: https://doi.org/10.1111/j.1365-2591.2007.01240.x
Alcalde MP, Guimarães BM, Fernandes SL, Amoroso-Silva PA, Bramante CM, Vivan RR, et al. Revascularização pulpar: considerações técnicas e implicações clínicas. Salusvita. 2014;33(3):415-432. Disponível em: http://bases.bireme.br/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&src=google&base=LILACS&lang=p&nextAction=lnk&exprSearch=737190&indexSearch=ID.
Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod. 2013;39(3):319-326. Disponível em: https://doi.org/10.1016/j.joen.2012.11.014
Lovelace TW, Henry MA, Hargreaves KM, Diogenes, A. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. J Endod, New York. 2011;37:133-138. Disponível em: https://doi.org/10.1016/j.joen.2010.10.009.
Hargreaves KM; Geisler, T.; Henry, M.; Wang, Y. Regeneration potential of the young permanent tooth: what does the future hold? J Endod, New York. 2008;34(7):51-56, 2008. Disponível em: https://doi.org/10.1016/j.joen.2008.02.032
Kim DS, Park HJ, Yeom JH, Seo JS, Ryu GJ, Park KH, Shin SI, Kim SY. Long-term follow-ups of revascularized immature necrotic teeth: three case reports. Int J Oral Sci. 2012;4(2):109-13. Disponível em: https://doi.org/10.1038/ijos.2012.23
Becerra P, Ricucci D, Loghin S, Gibbs JL, Lin LM. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization. J Endod. 2014;40(1):133-9. Disponível em: https://doi.org/10.1016/j.joen.2013.07.017
McCabe P. Revascularization of an immature tooth with apical periodontitis using a single visit protocol: a case report. Int Endod J. 2015;48(5):484-97. Disponível em: https://doi.org/10.1111/iej.12344
Bukhari S, Kohli MR, Frank F, Karabucak B. Outcome of Revascularization Procedure: A Retrospective Case Series. Journal of Endodontics. 2016;42(12):1752-1759. Disponível em: https://doi.org/10.1016/j.joen.2016.06.021.
Mohammadi Z, Abbott PV. On the Local Applications of Antibiotics and Antibioticbased Agents in Endodontics and Dental Traumatology. Intendod J. 2009;42(7):555-567. Disponível em: https://doi.org/10.1111/j.1365-2591.2009.01564.x
Mohammadi Z, Dummer PMH. Properties and applications of calcium hydroxide in endodontics and dental traumatology. International Endodontic Journal. 2011;44(8):697-730. Disponível em: https://doi.org/10.1111/j.1365-2591.2011.01886.x
Yassen GH, Chin J, Mohammedsharif AG, Alsoufy SS, Othman SS, Eckert G. The effect of frequency of calcium hydroxide dressing change and various pre- and inter-operative factors on the endodontic treatment of traumatized immature permanent incisors.Dental Traumatology. 2012;28(4):296-301. Disponível em:
https://doi.org/10.1111/j.1600-9657.2011.01089.x
Silveira CMM, Sebrão CCN, Vilanova LSR. Apexification of an Immature Permanent Incisor with the Use of Calcium Hydroxide: 16-Year Follow-Up of a Case. Case Rep Dent. 2015 Jun. Disponível em: https://doi.org/10.1155/2015/984590
Strom TA, Arora A, Osborn B, Karim N, Komabayashi T, Liu X. Endodontic Release System for Apexification with Calcium Hydroxide Microspheres. J Dent Res. 2012;91(11):1055–1059. Disponível em: https://doi.org/10.1177/0022034512459054
Otani K, Sugaya T, Tomita M, Hasewaga HM, Tenkumo T, Tanaka S, et al. Healing of experimental apical periodontitis after apicoectomy using different sealing materials on the resected root end. Dent Mater J. 2011;30(4):485-492. Disponível em: https://doi.org/10.4012/dmj.2010-158
Baek SH, Plenk H, Kim S. Periapical Tissue Responses and Cementum Regeneration with Amalgam, SuperEBA, and MTA as Root-End Filling Materials. J Endod. 2005;31(6):444-449. Disponível em: https://doi.org/10.1097/01.don.0000148145.81366.a5
Katsamakis S, Slot DE, Van der Sluis LW, Van der Weijden F. Histological responses of the periodontium to MTA: a systematic review. J Clin Periodontol. 2013;40(4):334-344. Disponível em: https://doi.org/10.1111/jcpe.12058
SousaNB, NunesMAC, VelosoKMM, Pereira, AFV. Mineral trioxide aggregate and the use as a material for retrofilling endodontic surgery. Rev Bras Odontol. 2014;71(2):144-147. Disponível em: http://revodonto.bvsalud.org/pdf/rbo/v71n2/a06v71n2.pdf
Arx T, Jensen SS, Janner SFM, Hanni S, Bornstein MM. 10-year Follow-up Study of 119 Teeth Treated with Apical Surgery and Root-end Filling with Mineral Trioxide Aggregate. Journal of Endodontics. 2019;45(4):394-401. Disponível em: https://doi.org/10.1016/j.joen.2018.12.015
Torres FFE, Guerreiro-Tanomaru JM, Bosso-Martelo R. Solubility, Porosity, Dimensional and Volumetric Change of Endodontic Sealers. Braz Dent J. 2019;30. Disponível em: https://doi.org/10.1590/0103-6440201902607
Delorme B, Chateauvieux S, Charbord P. The concept of mesenchymal stem cells. Regen Med. 2006;1(4):497-509. Disponível em: https://doi.org/10.2217/17460751.1.4.497
Wang Q, Lin XJ, Lin ZY, Liu GX, Shan XL. Expression of vascular endothelial growth factor in dental pulp of immature and mature permanent teeth in human. Shanghai Kou Qiang Yi Xue, Shanghai. 2007;16(3):285-289. Disponível em: PMID: 17660916.
Seo BM, Miura M, Gronthos S, Bartold PM, Batouli S, Brahim J, Young M, Robey PG, Wang CY, Shi S. Investigation of multipotent postnatal stem cells from human periodontal ligament. Lancet. 2004; 16: 364 (9429): 149-55. Disponível em: https://doi.org/10.1016/S0140-6736(04)16627-0
Huang GT, Gronthos S, Shi S. Mesenchymal stem cells derived from dental tissues vs. those from other sources: their biology and role in regenerative medicine. J Dent Res. 2009;88(9):792-806. Disponível em: https://doi.org/10.1177/0022034509340867
Wang Y, Zhu X, Zhang C. Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient. Journal of Endodontics. 2015;41(9):1571-1575. Disponível em: https://doi.org/10.1016/j.joen.2015.04.022
Nosrat A, Homayounfar N, Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. J Endod. 2012;38(10):1428-1434. Disponível em: https://doi.org/10.1016/j.joen.2012.06.025
Erdem AP, Sepet E. Mineral trioxide aggregate for obturation of maxillary central incisors with necrotic pulp and open apices. Dent Traumatol. 2008;24(5):38-41. Disponível em: https://doi.org/10.1111/j.1600-9657.2008.00636.x
