Emprego da pasta CTZ como material obturador em odontopediatria: uma revisão de literatura

Abstract

The endodontic technique using CTZ paste (chloramphenicol, tetracycline and zinc oxide and eugenol) in primary molars has achieved prominence in recent years. This was due to the fact that this method is considered, by a large portion of the dental community, to be a successful practice. The preservation of primary dentition in the oral cavity, even the physiological exfoliation of permanent teeth, is extremely important. Thus, when the cariogenic process extends in such a way that it reaches the dental pulp, the use of pulp therapy is indicated. However, there is a need for experimental research to support the effectiveness of its indication as well as the main materials used in the procedure. The objective of this work is to review and discuss the literature on the antibiotic paste CTZ (Tetracycline Chlorophenicol and Zinc oxide and Eugenol), presenting the advantages and disadvantages of its clinical use. Also objective are: to identify the functionality of the CTZ paste in the endodontic treatment of deciduous teeth and to discuss the reasons that encourage the use of the antibiotic CTZ paste to perform the endodontic technique in pediatrics. As it is a subject considered current, whose discussion is gaining notoriety in the dental scenario, there are not many works related to the theme available in the literature. A bibliographic survey was carried out in the PubMed and ScielO database, considering the publications that took place between 2006 and 2019, in Portuguese and English. The inclusion criteria were mainly focused on research, however, some literature reviews were added to the work. The exclusion criteria, on the other hand, were articles that evaded the topic and opinion articles. Thus, 24 studies were selected for analysis. The evaluation of the collected studies revealed that most authors argue that CTZ has a good clinical performance, exhibiting evident biocompatibility, low toxicity and high antibacterial and bacteriostatic power, the latter being responsible for promoting antisepsis since its placement in the canal mouth. It was also found that the paste presents ease and simplicity in its application, which is topical and can be performed in a single session. The stabilization of bone resorption has also been highlighted as a positive result of its use, as well as its low cost when compared to conventional endodontic treatment. Care with staining was reported, as well as the need for the correct proportion of its components. Therefore, it was concluded that pediatric endodontics should consider and study more and more procedures that employ more simplified techniques. Despite this, this strategy should provide the same satisfactory results, both clinical and radiographic, as traditional procedures. Despite the innumerable advantages presented by the antibiotic paste, the need for further studies is emphasized for a greater understanding of its properties, verifying the feasibility of its insertion in clinical practice. Likewise, conducting studies on the proportionality of the components of the paste is essential, since the clinical methodology recommends the lowest possible concentration of applied drug capable of effectively performing its function.