Revascularização pulpar em dentes com rizogênese incompleta: revisão de literatura

Abstract

In cases of pulp necrosis in teeth with incomplete rhizogenesis, root development is compromised, and problems may occur that make the apical closure of the tooth element unfeasible. The endodontic treatment, in these cases, becomes complex, as there is a wide canal, with thin walls and diverging to the apical one. Currently, regenerative therapies have been promoted and discussed in order to promote adequate root development. Within this context, the objective of this work is, through a narrative literature review, to analyze the different protocols of pulp revascularization, considering the different techniques that have been advocated. For this, this study was carried out, being a descriptive literature review with a qualitative methodological approach, which used the PUBMED/Medline, Scielo and Lilacs platforms as bases for research, with publication date between 2011 and 2021. After pulp revascularization in teeth with incomplete rhizogenesis, instrumentation of the canal can be dispensed with, avoiding the increase in fragility of the walls and damage to the stem cells present in the apical region of these elements. Decontamination can be performed during irrigation by the association of 17% EDTA and 2.5% sodium hypochlorite, in addition to the use of intracanal medication, using a paste based on three different antibiotics and a calcium hydroxide base . After a period of up to 21 days, bleeding is induced with the aid of an endodontic file, with the possibility of introducing fibrin-rich plasma (FRP) into the channel. Finally, a cervical tampon is applied with a bioceramic repair cement, followed by definitive restoration of the tooth. Thus, it was concluded that despite the differences in irrigation protocols, intracanal medication, clot formation, use of PRF and sealing material used for pulp revascularization, the clinical success of the procedure has been observed.