Materiais obturadores utilizados em pulpectomias de dentes decíduos: revisão de literatura

Abstract

Pulpectomy helps to preserve primary teeth with irreversible pulp pathologies in a symptom- free state until they are replaced by their successor naturally, avoiding extraction. Many laboratory studies have been carried out to investigate the effectiveness of different filling techniques and filling materials for primary teeth, however, there is still no consensus on the gold standard material for this purpose. The purpose of this work is to review and discuss the literature about dental materials used in deciduous teeth pulpectomy, evaluating the radiographic performance and the success rates presented by such materials. The database PubMed was consulted to conduct this literature review. English clinical trial publications from the last 20 years with the abstract available and which studied filling materials used in deciduous teeth pulpectomy were included; 26 articles were selected. Most studies were carried out on primary molars (92.30%). In addition, most in vivo studies have followed the clinical performance of the materials over 12 (25%) and 18 months (25%). The most evaluated clinical criteria were absence of pain, abnormal mobility, swelling, sensitivity to percussion and palpation, fistula and abscess. Regarding the radiological criteria, the most cited were the absence of interradicular or periapical radiolucency, reduction in the size of the previously existing radiolucent area; non-physiological internal or external resorption, evidence of bone regeneration, continuity of the hard lamina and normal or slightly thickened periodontal ligament space. Zinc oxide and eugenol were analyzed in 25.5% of publications; materials such as endoflas, vitapex, metapex, zinc oxide added to other materials, calcium hydroxide paste, 3Mix paste, among others, were also studied. Each study differs concerning sample selection, treatment procedure and follow-up period. There is no way to point out the superiority of a given material compared to another, considering that each has its advantages and disadvantages. Clinical performance proved to be superior to radiographic success, which points to the importance of postoperative radiographs. The success rates of the studied materials can be affected by several factors, such as the type of filling material, the anatomy of the root canal and the type of restoration performed.