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Antecedentes: el tratamiento de pulpotomía conserva la vitalidad pulpar de los dientes y promueve la cicatrización. Objetivo: determinar los avances del tratamiento de pulpotomía parcial en los últimos 10 años. Criterio de selección: artículos de estudios analíticos, experimentales ECA (ensayos clínicos controlados aleatorizados), revisiones sistemáticas que traten sobre pulpotomía parcial o total. Artículos con nivel de evidencia moderado a alto y seguimiento, control clínico y radiográfico en dientes tratados con pulpotomía publicados desde el año 2011 al 2022. Recopilación y análisis de datos: la evaluación de la calidad metodológica, riesgo de sesgo y extracción de datos se realizó de forma independiente. La calidad metodológica se evaluó con la guía PRISMA para revisiones sistemáticas y metaanálisis; CONSORT para ensayos clínicos aleatorizados y STROBE para estudios observacionales. El análisis del riesgo de sesgo en los estudios observacionales se evaluó con la herramienta de la Escala Newcastle-Ottawa y las revisiones sistemáticas con la herramienta (RoB2) Cochrane. Resultados: de los 54 estudios seleccionados, 11 fueron Revisiones sistemáticas, 33 ensayos clínicos aleatorizados y 10 estudios observacionales. Se observo buen pronóstico en dientes con ápice cerrado, el anestésico más utilizado fue con vasoconstrictor, el hipoclorito de sodio es el irrigante y hemostático más utilizado y los cementos Biocerámicos presentaron el mejor porcentaje de éxito. Conclusiones: los hallazgos de la revisión indican altas tasas de éxito para la pulpotomía; sin embargo, existe un riesgo moderado de sesgo en los estudios incluidos, por lo que los resultados generales deben interpretarse con cautela. Record: pulpotomy is a treatment that promotes pulp healing. Objective: To the aim of this review was to assess the progress of partial pulpotomy treatment in the last 10 years. Selection criteria: analytical articles, experimental studies CCT (Controled Clinical Trial), systematic reviews of partial or total pulpotomy. Articles with moderate to high evidence level and follow-up, clinical and radiographic control in teeth treated with pulpotomy published from 2011 to 2022. Data collection and analysis: the evaluation of methodological quality, risk of bias and data extraction was carried out independently. Methodological quality was assessed with the PRISMA guide for systematic reviews and meta-analyzes, CONSORT for randomized clinical trials and STROBE for observational studies. Risk of bias analysis in observational studies was assessed using the Newcastle-Ottawa Scale tool and systematic reviews using the Cochrane (RoB2) tool. Results: from 54 studies selected, 11 were systematic reviews, 33 randomized clinical trials and 10 observational studies. Good prognosis was observed in teeth with closed apex, the most used anesthetic was with vasoconstrictor, sodium hypochlorite is the most used irrigant and hemostatic and the Bioceramic cements presented the best success rate. Conclusions: the findings of the review indicate high success rates for pulpotomy; however, there is a moderate risk of bias in the included studies, so the overall results should be interpreted with caution. Especialista en Endodoncia http://www.ustabuca.edu.co/ustabmanga/presentacion Especialización

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz Objetivo: Responder à pergunta baseada na nomenclatura PICOT: em dentes decíduos de crianças (P), a pulpotomia com os biocerâmicos de 2ª geração (I), comparado com MTA (C) resulta num melhor sucesso clínico e radiográfico (O) que são avaliados em follow-ups até 24 meses (T)? Materiais e Métodos: As pesquisas se restringiram ao período entre 2011 e 2021 em bases de dados eletrónicas universais. Através da meta-análise, o resultado clínico e radiográfico de biocerâmicos em pulpotomias de dentes decíduos, nos diferentes meses de acompanhamento. A heterogeneidade foi calculada por meio da estatística do teste I2 (p < 0,1). Resultados: 14 estudos clínicos foram selecionados para análise, tendo em conta os critérios de inclusão e exclusão. As taxas de sucesso para os novos biocerâmicos com base de MTA VS MTA aos 3 meses de controlo clínico (RR=1.00; 95%IC=0.97-1.03) e radiográfico (RR=0.97; 95%IC=0.93-1.02); aos 6 meses de controlo clínico (RR=1.00; 95%IC=0.97-1.02) e radiográfico (RR=1.00; 95%IC=0.97-1.02); aos 12 meses de controlo clínico (RR=1.01; 95%IC=0.98-1.04) e radiográfico (RR=1.01; 95%IC=0.98-1.04); aos 24 meses de controlo clínico (RR=0.99; 95%IC=0.83-1.17) e radiográfico (RR=0.99; 95%IC=0.83-1.17). As taxas de sucesso para o Biodentine VS MTA foram aos 3 meses de controlo clínico (RR=1.00; 95%IC= 0.97-1.03) e radiográfico (RR=1.00; 95%IC=0.96-1.03); aos 6 meses de controlo clínico (RR=1.00; 95%IC=0.98-1.02) e radiográfico (RR=1.00; 95%IC=0.98-1.02); aos 9 meses de controlo clínico (RR=0.98;95%IC=0.95-1.02) e radiográfico (RR=1.00;95%IC=0.95-1.05); aos 12 meses de controlo clínico (RR=1.01; 95%IC=0.99-1.03) e radiográfico (RR=1.01; 95%IC=0.98-1.04); aos 18 meses de controlo clínico (RR=0.99; 95%IC=0.95-1.02) e radiográfico (RR=1.01; 95%IC=0.94-1.09); aos 24 meses de controlo clínico (RR=0.99; 95%IC=0.95-1.03) e radiográfico (RR=0.96; 95%IC=0.90-1.03). Conclusão: Tanto a nível clínico como radiográfico, entre os biocerâmicos de 1ª e 2ª gerações não existem diferenças estatisticamente significativas (valor-p>0.05), ao longo dos meses de follow-up. Objectives: To answer the question based on the PICOT nomenclature: in primary teeth (P), pulpotomy with 2nd generation bioceramics (I), compared with MTA (C) results in better clinical and radiographic success (O) which are considered in up to 24 months follow-ups (T)? Materials and Methods: Searches were restricted to the period between 2011 and 2021 in universal electronic databases. Through meta-analysis, the clinical and radiographic results of bioceramics in pulpotomies of deciduous teeth, in different months of follow-up. Heterogeneity was calculated using I2 test statistics (p < 0.1). Results: Success rates for the new MTA-based bioceramics VS MTA at 3 months of clinical (RR=1.00; 95%CI=0.97-1.03) and radiographic (RR=0.97; 95%CI=0.93-1.02); at 6 months of clinical control (RR=1.00; 95%CI=0.97-1.02) and radiographic (RR=1.00; 95%CI=0.97-1.02); at 12 months of clinical control (RR=1.01; 95%CI=0.98-1.04) and radiographic (RR=1.01; 95%CI=0.98-1.04); at 24 months of clinical control (RR=0.99; 95%CI=0.83-1.17) and radiographic (RR=0.99; 95%CI=0.83-1.17). Success rates for MTA VS Biodentine, were at 3 months of clinical (RR=1.00; 95%CI= 0.97-1.03) and radiographic (RR=1.00; 95%CI=0.96-1.03); at 6 months of clinical control (RR=1.00; 95%CI=0.98-1.02) and radiographic (RR=1.00; 95%CI=0.98-1.02); at 9 months of clinical control (RR=0.98;95%CI=0.95-1.02,) and radiographic (RR=1.00;95%CI=0.95-1.05); at 12 months of clinical control (RR=1.01; 95%CI=0.99-1.03) and radiographic (RR=1.01; 95%CI=0.98-1.04); at 18 months of clinical (RR=0.99; 95%CI=0.95-1.02) and radiographic (RR=1.01; 95%CI=0.94-1.09); at 24 months of clinical control (RR=0.99; 95%CI=0.95-1.03) and radiographic (RR=0.96; 95%CI=0.90-1.03). Conclusion: Both clinically and radiographically, between the 1st and 2nd generation bioceramics, there are no statistically significant differences (p-value>0.05), over the months of follow-up.

Objective. To determine the antibacterial effect of triantibiotic paste (3MIX-MP) and chloramphenicol-tetracycline-ZOE (CTZ) antibiotic paste at 24, 48, 72 hours and 7 days on Enterococcus faecalis. Methods. Experimental, in vitro, comparative study, with a non-probabilistic sample for convenience of 210 paper discs, distributed in 30 Petri dishes previously prepared with Mitis Salivarius agar and Mueller Hinton agar and inoculated with strains of Enterococcus faecalis ATCC® 29212. The method was used. Kirby-Bauer, inoculated with a 0.5 McFarland suspension of Enterococcus faecalis. Filter paper discs were placed inside the wells and 10 µl of antimicrobial pastes and control were supplied. The positive control was zinc oxide-eugenol cement discs; halo diameters were measured with a vernier caliper. A repeated measures ANOVA was used for intragroup comparisons, one-way ANOVA for intergroup comparisons, and Tukey’s post hoc tests. Results. After 24 hours, the 3MIX-MP paste obtained larger inhibition zone diameters than the CTZ paste with an average of 39,24 mm and 34,19 mm, respectively, and a minimum of 36,26 mm and 26,38 mm at 24 hours. 7 days. Statistically significant differences were observed between the halos obtained from the 3MIX-MP paste and the CTZ paste, except for the control after 48 hours. Conclusions. It was determined that the 3MIX-MP paste has a greater inhibitory action in vitro compared to the CTZ paste, the diameter of the inhibitory halos decreased as the exposure time to the microorganism increased., Objetivo. Determinar el efecto antibacteriano de la pasta triantibiótica (3MIX-MP) y pasta antibiótica cloranfenicol-tetraciclina-ZOE (CTZ) a las 24, 48, 72 horas y 7 días sobre Enterococcus faecalis. Métodos. Estudio experimental, in vitro, comparativo, con muestra no probabilística por conveniencia de 210 discos de papel, distribuidos en 30 placas Petri previamente preparadas con agar Mitis Salivarius y agar Mueller Hinton e inoculadas con cepas de Enterococcus faecalis ATCC® 29212. Se utilizó el método Kirby-Bauer, inoculados con suspensión de Enterococcus faecalis a 0,5 McFarland. Se colocaron los discos de papel filtro dentro de los pocillos y se suministró 10 µl de pastas antimicrobianas y control. El control positivo fueron discos de cemento de óxido de zinc-eugenol; los diámetros de los halos fueron medidos con un calibrador vernier. Se utilizó un ANOVA de medidas repetidas para las comparaciones intragrupo, ANOVA de un factor para comparaciones intergrupo y pruebas post hoc de Tukey. Resultados. A las 24 horas, la pasta 3MIX-MP obtuvo mayores diámetros de halos de inhibición que la pasta CTZ con un promedio de 39,24 mm y 34,19 mm respectivamente y un mínimo de 36,26 mm y 26,38 mm a los 7 días. Se observaron diferencias estadísticamente significativas entre los halos obtenidos de la pasta 3MIX-MP y pasta CTZ, excepto el control después de las 48 horas. Conclusiones. Se determinó que la pasta 3MIX-MP posee una mayor acción inhibitoria in vitro en comparación a la pasta CTZ, el diámetro de los halos inhibitorios disminuyó conforme aumentó el tiempo de exposición al microorganismo.

Introduction: The main function of endodontic treatment in primary teeth is to obtain a correct conformation of the root canals, enabling an adequate disinfection, in order to avoid possible extractions, as it is also used to preserve masticatory, aesthetic and phonetic functions, which are still under development. Antibiotic-containing pastes have shown great clinical relevance and a high success rate. Objective: Evaluate the available scientific evidence on the use of anti-biotic toothpaste CTZ as filling material for primary teeth in order to draw attention to the risks and benefits of using this medication. Material and methods: Search strategies were developed for the following databases: PubMed, Scielo, Cochrane and Lilacs. The guiding question of the research was: What are the main clinical indications for the use of CTZ antibiotic paste in the endodontic treatment of deciduous teeth and what are the advantages and disadvantages of using this technique? Results: The results demonstrated significantly higher concentrations of better clinical results in techniques that made use of pulpotomy with the CTZ paste for the treatment of severe caries. Regarding the clinical success of the included clinical studies, about 66.7% had complete clinical success, with no postoperative changes. Regarding radiographic success, 55.7% of the studies had total radiographic success, and only 33.3% had a result below 95%. Conclusion: Despite the known clinical success of the endodontic technique, there is a need to develop studies in order to verify the clinical and radiographic results of treated primary teeth. Also, verify the influence of the treatment on the development of permanent successor teeth. Introducción: El tratamiento endodóntico en dientes caducifolios tiene como función principal obtener una correcta conformación de los conductos radiculares, posibilitando una adecuada desinfección, con el objetivo de evitar posibles desperdicios, además de ser utilizado para preservar las funciones masticatorias, estéticas y fonéticas, que aún se encuentran en desarrollo. Las pastas que contienen antibióticos han demostrado una gran relevancia clínica y una alta tasa de éxito. Objetivo: Evaluar la evidencia científica disponible sobre el uso de la pasta antibiótica CTZ como material obturador de los dientes deciduos con el fin de llamar la atención sobre los riesgos y beneficios del uso de este medicamento. Material y Métodos: Se elaboraron estrategias de búsqueda para las siguientes bases de datos: PubMed, Scielo, Cochrane y Lilacs. La pregunta orientadora de la investigación fue: ¿Cuáles son las principales indicaciones clínicas para el uso de pasta antibiótica CTZ en el tratamiento endodóntico de dientes temporales y cuáles son las ventajas y desventajas de utilizar esta técnica? Resultados: Los resultados demostraron concentraciones significativamente más altas de mejores resultados clínicos en técnicas que utilizaron pulpotomía con pasta de CTZ para el tratamiento de caries severas. En cuanto al éxito clínico de los estudios clínicos incluidos, alrededor del 66,7% tuvo éxito clínico completo, sin cambios postoperatorios. En cuanto al éxito radiográfico, el 55,7% de los estudios tuvo éxito radiográfico total, y solo el 33,3% tuvo un resultado inferior al 95%. Conclusión: A pesar del éxito clínico conocido de la técnica de endodoncia, existe la necesidad de desarrollar estudios para verificar los resultados clínicos y radiográficos de los dientes caducifolios tratados. Además, verifique la influencia del tratamiento en el desarrollo de dientes permanentes sucesores. Introdução: O tratamento endodôntico em dentes decíduos tem como principal função obter uma correta conformação dos canais radiculares, possibilitando uma adequada desinfecção, visando evitar possíveis exodontias, como também é utilizada para preservar as funções mastigatórias, estéticas e fonéticas, que ainda estão em desenvolvimento. Objetivo: Avaliar a evidência científica disponível sobre a utilização da pasta antibiótica CTZ como material obturador de dentes decíduos com o intuito de chamar atenção para os riscos e benefícios do uso desta medicação. Material e Métodos: Estratégias de busca foram elaboradas para as seguintes bases de dados: PubMed, Scielo, Cochrane e Lilacs. A pergunta norteadora da pesquisa foi: Quais as principais indicações clínicas para o uso da pasta antibiótica CTZ no tratamento endodôntico de dentes decíduos e quais são as vantagens e desvantagens da utilização dessa técnica? Resultados: Os resultados demonstraram concentrações significativamente mais altas de melhores resultados clínicos em técnicas que fizeram uso da pulpotomia com a pasta CTZ para o tratamento da cárie severa. No que se refere ao sucesso clínico dos estudos clínicos incluídos, cerca de 66,7% apresentou total sucesso clínico, sem alterações pós-operatórias. Em relação ao sucesso radiográfico, 55,7% dos estudos apresentou total sucesso radiográfico, e apenas 33,3% apresentou resultado inferior a 95%. Conclusão: Apesar do conhecido sucesso clínico da técnica endodôntica, há a necessidade do desenvolvimento de estudos com a finalidade de verificar os resultados clínicos e radiográficos dos dentes decíduos tratados. Além disso, verificar a influência do tratamento no desenvolvimento dos dentes permanentes sucessores.

Esse estudo objetivou comparar o manchamento dentário de incisivos bovinos simulando fraturas complicadas com exposição pulpar em dentes imaturos, tratados por pulpotomia total e parcial usando Biodentine (BD) e Bio-C repair (BCR) e avaliou a citotoxicidade dos materiais às células pulpares (hDPCs). Setenta e dois incisivos bovinos extraídos foram preparados para simular fraturas coronárias em um dente imaturo. Na simulação do tecido pulpar, as raízes foram preenchidas com uma mistura de ágar e sangue (grupo controle), sobre as quais foram colocados os materiais BD ou BCR com aproximadamente 2 mm de espessura. As análises de avaliação de cor das amostras foram realizadas antes e imediatamente após a pulpotomia e repetidas aos 30, 60 e 90 dias. As hDPCs foram colocadas em contato com diferentes diluições de meios de cultura previamente expostos a tais materiais e testadas quanto à viabilidade celular usando o ensaio MTT. Posteriormente, as hDPCs foram estimuladas com lipopolissacarídeos (LPS) e expostas aos extratos, para medição quantitativa de espécies reativas de oxigênio (EROS) e óxido nítrico (ON). Os dados foram avaliados por ANOVA seguido do teste de Tukey e Dunnet (α = 0,05). Quanto à alteração de cor, houve diferenças significantes para “material de pulpotomia” (P0,05). BD apresentou valores de EROS e ON semelhantes aos dois grupos controle (P>0,05). Tanto BCR quanto BD quando utilizados em pulpotomia total ou parcial podem alterar significativamente a cor dos dentes. Embora ambos materiais sejam biocompatíveis, BCR apresentou uma redução na produção de EROS e ON em hDPCs estimuladas com LPS. This study aimed to compare tooth discoloaration in immature teeth mimicking total and partial pulpotomy using Biodentine (BD) and Bio-C repair (BCR) and evaluated the cytotoxicity of the materials to pulp cells (hDPCs). Seventy-two bovine mandibular incisors were prepared to simulate complicated coronary fractures in an immature tooth. In the pulp tissue simulation, the roots were filled with a mixture of agar and blood (control group), and BD and BCR were placed on it with approximately 2 mm of thickness. The color evaluation analyzes of the samples were performed before and immediately after the pulpotomy and repeated at 30, 60 and 90 days. The hDPCs were contacted with different dilutions of culture media previously exposed to such materials and tested for cell viability using the MTT assay. Subsequently, hDPCs were stimulated through contact with lipopolysaccharides (LPS) and exposed to extracts, for quantitative measurement of reactive oxygen species (ROS) and nitric oxide (NO). Data were evaluated by ANOVA followed by the Tukey and Dunnet test (α = 0.05).For tooth descoloration, there were significant differences for “pulpotomy material” (P0.05). BD showed ROS and NO values similar to the two control groups (P>0.05). Both BCR and BD when used in total or partial pulpotomy can significantly change the color of teeth to a perceptible degree. Although both materials are biocompatible, BCR decreased the production of ROS and NO in hDPCs stimulated with LPS. Dissertação (Mestrado) 2024-07-21

Pulpotomy is a conservative techinique that offers maintenance of the integrity of the thooth and its supporting tissues. Advances in the field of cellular and molecular biology have contributed to the advento f a series of new materials, more biocompatible, suitable for pulpotomy of primary teeth. The use of lasers has excelente impacto n pulpo therapy for these theeth, in such a way that it can replace pharmacotherapeutic techniques. The objective was to compares the effectiveness of lasers in pulpotomu of primary theeth, describing procedures and its influence on tissue repair, in addition to discussing its applicability in conjunction with materials of the Pulp tooth complex. A bibliographic survey was carried out in the Scielo, Lilacs, Bvs and Pubmed databases using the descriptors: “Dental pulp”, “Pulpotomy” and “Lasertherapy”. Of the eight articles considered by this integrative literature review, it was found that the most used lasers for the treatment of pulpotomy in human primary teeth are the Diode and Low Intensity Laser, being considered an excellent treatment alternative, as it presents satisfactory results for irradiated tissues. It was concluded that the Low Intensity Laser will be the choice for performing pulpotomy on primary teeth, as it contributes to the increase of metabolism, cell proliferation and maturation, amount of granulation tissue and reduction of inflammatory mediators, leading to the process healing. Los avances en el campo de la biología celular y molecular han contribuido al advenimiento de una serie de nuevos materiales, más biocompatibles, aptos para pulpotomías de dientes temporales. El uso de láser ha tenido un buen impacto en la terapia pulpar de estos dientes, de tal forma que puede sustituir a las técnicas farmacoterapéuticas. El objetivo fue comparar la efectividad de los láseres en pulpotomías de dientes temporales, describiendo el uso de esta tecnología en estos procedimientos y su influencia en la reparación tisular, además de discutir su aplicabilidad en conjunto con materiales del complejo pulpo dentinario. Se realizó un levantamiento bibliográfico en las bases de datos Scielo, Lilacs, Bvs y Pubmed utilizando los descriptores: “Pulpa dental”, “Pulpotomía” y “Terapia láser”. En los siete artículos seleccionados por esta revisión integrativa de la literatura, se verificó que los láseres más utilizados para el tratamiento de pulpotomías en dientes temporales humanos son el Láser de Diodo y de baja intensidad, siendo considerado una excelente alternativa de tratamiento, por presentar resultados satisfactorios para la tejidos irradiados. Se concluyó que el Láser de Baja Intensidad es de elección para la realización de pulpotomías en dientes temporales, ya que contribuye al aumento del metabolismo, proliferación y maduración celular, cantidad de tejido de granulación y reducción de mediadores inflamatorios, conduciendo al proceso de cicatrización. Os avanços no campo da biologia celular e molecular, colaboraram para o advento de uma série de novos materiais, mais biocompatíveis, adequados para a pulpotomia dos dentes decíduos. O emprego dos lasers tem tido uma boa repercussão na terapia pulpar desses dentes, de tal forma que pode substituir técnicas farmacoterapêuticas. Objetivou-se comparar a eficácia dos lasers em pulpotomia de dentes decíduos, descrevendo a utilização da referida tecnologia nesses procedimentos e sua influência no reparo tecidual, além de discutir sua aplicabilidade em conjunto com materiais do complexo dentino pulpar. Realizou-se um levantamento bibliográfico nas bases de dados Scielo, Lilacs, Bvs e Pubmed utilizando os descritores: “Polpa dentária”, “Pulpotomia” e “Terapia a Laser”. Nos sete artigos selecionados por essa revisão de literatura integrativa, foi verificado que os Lasers mais utilizados para o tratamento de pulpotomia em dentes decíduos humanos são os Laser de Diodo e de baixa intensidade, sendo considerada uma excelente alternativa de tratamento, por apresentar resultados satisfatórios para os tecidos irradiados. Concluiu-se que o Laser de Baixa Intensidade é o de escolha para a realização de pulpotomia em dentes decíduos, visto que contribui para o aumento do metabolismo, da proliferação e maturação celular, quantidade de tecido de granulação e redução dos mediadores inflamatórios, levando ao processo de cicatrização.

Resumen Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo. Abstract Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines.

Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines. RESUMEN: Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo.

El siguiente trabajo tiene como objetivo mejorar la práctica clínica de la Odontopediatría para los tratamientos pulpares de las piezas dentarias temporarias estudiando los resultados entre distintos materiales utilizados, para lo cual se trataron molares de piezas dentaria temporarias con diagnóstico de pulpitis y necrosis en pacientes niños de 5 a 9 años de edad. En las piezas dentarias con diagnóstico de pulpitis, se realizó biopulpectomía parcial terapéutica con Formocresol, fórmula de Morawa, en 17 molares, pulpotomia con MTA en 15 molares y pulpotomía con Biodentine en 15 molares (Figura1). En las piezas dentarias con necrosis pulpar se realizó tratamiento medicamentoso con Formocresol con la fórmula de Morawa en 23 molares, y la técnica LSTR – NIET con pasta triantibiótica en 20 molares (Figura 2). La monitorización de los tratamientos realizados en los pacientes infantiles se llevó a cabo solamente a los 3 meses de realizarse los tratamientos en algunos de ellos. Debido a los problemas actuales de la pandemia provocada por el COVID-19, no pudo realizarse la revisión clínica y radiológica de los tratamientos realizados en su debido tiempo de acuerdo a lo estipulado en el proyecto original, es decir a los 6, 12 y 24 meses. Los resultados obtenidos fueron satisfactorios con la utilización de biomateriales debido a su biocompatiblidad y bioiactividad., The following work aims to improve the clinical practice of Pediatric Dentistry for pulp treatments of temporary teeth by studying the results between different materials used, for which temporary tooth molars diagnosed with pulpitis and necrosis were treated in patients children 5 to 9 years old. In the teeth diagnosed with pulpitis, therapeutic partial biopulpectomywas performed with Formocresol, Morawa's formula, in 17 molars, pulpotomy with MTA in 15 molars and pulpotomy with Biodentine in 15 molars (Figure 1). In the teeth with pulpal necrosis, drug treatment was performed with Formocresol with the Morawa formula in 23 molars, and the LSTR – NIET technique with triantibiotic paste in 20 molars (Figure 2). The monitoring of the treatments carried out in the child patients was carried out only 3 months after the treatments were carried out in some of them. Due to the current problems of the pandemic caused by COVID-19, the clinical and radiological review of the treatments carried out in due time could not be carried out according to what was stipulated in the original project, that is, at 6, 12 and 24 months. The results obtained were satisfactory with the use of biomaterials due to their biocompatibility and bioactivity., Facultad de Odontología

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz Introdução: A medicina dentária, em constante evolução, é hoje mais conservadora e menos invasiva. A pulpectomia, tratamento padrão para pulpite irreversível em dentes permanentes maduros, é um tratamento complexo, demorado e invasivo, enfraquecendo o dente mecanicamente e privando-o das suas capacidades de defesa. Com a evolução dos biomateriais, a pulpotomia cameral pode representar uma alternativa interessante à pulpectomia em dentes permanentes maduros com pulpite irreversível. Objetivos: Realizar uma revisão narrativa da literatura sobre a pulpotomia total como tratamento para pulpite irreversível em dentes permanentes maduros. Método: Uma pesquisa nas bases de dados Medline/PubMed, Science Direct e Cochrane Library, limitada a artigos em língua inglesa, é realizada nos últimos dez anos. São usadas diferentes palavras-chave e as suas combinações. Resultados: Os resultados dos estudos clínicos e histológicos convergem para admitir que os cimentos à base de silicato de cálcio (MTA, Biodentine™, CEM) são os materiais de escolha no caso de pulpotomia total. Resultados conflitantes são relatados para hidróxido de cálcio. Conclusão: A pulpotomia total é um procedimento terapêutico para pulpite irreversível em dentes permanentes maduros. No entanto, novos estudos são necessários para consolidar essa abordagem terapêutica. Introduction: Dental medicine, constantly evolving, is now more conservative and less invasive. Pulpectomy, the standard treatment for irreversible pulpitis in mature permanent teeth, is a complex, time-consuming and invasive treatment, weakening the tooth mechanically and depriving it of its defense capabilities. With the evolution of biomaterials, cameral pulpotomy may represent an interesting alternative to pulpectomy in mature permanent teeth with irreversible pulpitis. Objectives: To perform a narrative review of the literature on total pulpotomy as a treatment for irreversible pulpitis in mature permanent teeth. Method: A search in Medline/PubMed, Science Direct and Cochrane Library databases, limited to English language articles, is performed for the last ten years. Different keywords and their combinations are used. Results: The results of clinical and histological studies converge to admit that calcium silicate-based cements (MTA, Biodentine™, CEM) are the materials of choice in case of total pulpotomy. Conflicting results are reported for calcium hydroxide. Conclusion: Total pulpotomy is a therapeutic procedure for irreversible pulpitis in mature permanent teeth. However, further studies are needed to consolidate this therapeutic approach.

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Introduction: The pulpotomy procedure is conventionally done with formocresol, however, due to its mutagenic characteristics, new filling materials were developed as an alternative. Objective: The aim of this study was to review the literature in an integrative way regarding the most suitable filling material for pulpotomy in primary teeth. Methodology: The databases searched were Pubmed and Medline. The descriptors used for search were: “child”, “children”, “primary teeth”, “tooth, deciduous”, “primary tooth”, "pulpotomy", "pediatric dentistry", "endodontics", "root canal filling materials", "materials", "material", "biodentine", "mineral trioxide aggregate", "formocresol", "formocresols", "cytotoxicity", "biocompatible materials", "biocompatibility", "radiopacity", "radiographic" and "radiography, dental". The inclusion criteria were clinical studies, retrospective studies and prospective studies published from 2016 to 2021, in English or Portuguese. The exclusion criteria were thesis, dissertations, monographs, letters to the editor, textbooks and literature reviews. Results: After the search of the articles, 9 articles from both databases were included in the literature review, with higher prevalence of clinical trials. Conclusion: The most recommended filling materials for pulpotomies in primary teeth are Biodentine and Mineral Trioxide Aggregate. The filling material must be chosen according to the criteria of the professional and the patient’s case. It also needs to be considered the costs and the collaboration of the patient during the treatment. Introducción: El procedimiento de pulpotomía se realiza convencionalmente con formocresol, sin embargo, debido a sus características mutagénicas, se desarrollaron nuevos materiales de obturación como alternativa. Objetivo: Realizar una revisión integradora de la literatura sobre el material de obturación más adecuado para la pulpotomía de los dientes primários. Metodología: La búsqueda se realizó en las bases de datos Pubmed y Medline, utilizando los descriptores: “child”, “children”, “primary teeth”, “tooth, deciduous”, “primary tooth”, "pulpotomy", "pediatric dentistry", "endodontics", "root canal filling materials", "materials", "material", "biodentine", "mineral trioxide aggregate", "formocresol", "formocresols", "cytotoxicity", "biocompatible materials", "biocompatibility", "radiopacity", "radiographic" y "radiography, dental". Se incluyeron ensayos clínicos, estudios retrospectivos y estudios prospectivos, publicados entre 2016 y 2021, en inglés o portugués. Los criterios de exclusión fueron tesis, disertaciones, monografías, cartas al editor, libros y reseñas de literatura. Resultados: La búsqueda resultó en 9 artículos de ambas bases de datos, con una mayor prevalencia de ensayos clínicos. Conclusión: El material más recomendado para la realización de pulpotomías en dientes primarios es Biodentine y Mineral Trioxide Aggregate. La elección debe hacerse de acuerdo con el criterio del profesional y el caso del paciente. Es necesario considerar los costos y la cooperación del paciente durante el tratamiento. Introdução: O processo de pulpotomia convencionalmente é feito com formocresol, porém, devido as suas características mutagênicas, novos materiais obturadores foram desenvolvidos como alternativa. Objetivo: Revisar a literatura de forma integrativa a respeito do material obturador mais adequado para pulpotomia de dentes decíduos. Metodologia: A busca ocorreu nas bases de dados Pubmed e Medline, por meio dos descritores: “child”, “children”, “primary teeth”, “tooth, deciduous”, “primary tooth”, "pulpotomy", "pediatric dentistry", "endodontics", "root canal filling materials", "materials", "material", "biodentine", "mineral trioxide aggregate", "formocresol", "formocresols", "cytotoxicity", "biocompatible materials", "biocompatibility", "radiopacity", "radiographic" e "radiography, dental". Foram incluídos ensaios clínicos, estudos retrospectivos e estudos prospectivos, publicados entre 2016 e 2021, em inglês ou português. Os critérios de exclusão foram teses, dissertações, monografias, cartas ao editor, livros e revisões de literatura. Resultados: A pesquisa resultou em 9 estudos de ambas as bases de dados, com maior prevalência de ensaios clínicos. Conclusão: O material mais recomendado para realização de pulpotomias em dentes decíduos é o Biodentine e Mineral Trioxide Aggregate, devendo a escolha ser feita de acordo com o critério do profissional e caso do paciente. É preciso que seja considerado os custos e colaboração do paciente durante o tratamento.

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Justificativa /objetivos: A pulpotomia é uma terapia pulpar conservadora que visa manter a vitalidade da polpa sem a necessidade de procedimentos mais radicais como a pulpectomia ou exodontia. O objetivo desta revisão foi fornecer uma síntese da literatura avaliando a eficácia clínica e radiográfica do uso de hipoclorito de sódio (NaOCl) na pulpotomia de dentes decíduos e compará-lo com outros materiais utilizados para este procedimento. Metodologia: As buscas bibliográficas foram realizadas nas bases de dados Medline via PubMed, Medline via Ovid, Scopus, Lilacs, Embase, Biblioteca Cochrane e Web of Sciences. A busca na literatura cinzenta também foi realizada no Google Scholar, OpenGray, National Institute for Health and Care Excellence (NICE) e ProQuest. Foram incluídos ensaios clínicos randomizados, ensaios clínicos não randomizados e estudos de coorte nos quais a pulpotomia em dentes decíduos com hipoclorito de sódio era comparada com a pulpotomia em dentes decíduos com outros materiais. Não foram colocadas restrições quanto ao idioma ou data de publicação ao pesquisar nas bases de dados eletrônicas. Os dados foram agrupados e analisados descritivamente. A avaliação qualitativa foi realizada de acordo com a ferramenta Cochrane de risco de viés. Foi utilizado o Rob-2 para ensaios clínicos randomizados, o ROBINS-I para ensaios clínicos não randomizados e a Escala de Newcastle-Ottawa para estudos de coorte. No software RevMan, foram realizadas meta-análises incorporando estudos metodologicamente homogêneos. Desfechos dicotômicos foram usados e incluíram sucesso clínico e radiográfico. O I2 foi utilizado para calcular a heterogeneidade dos estudos. Os resultados foram fornecidos em odds ratio e intervalo de confiança. Resultados: Um total de 2654 estudos foram inicialmente identificados por meio de buscas eletrônicas. Após descarte das duplicatas e leitura dos títulos e resumos dos artigos selecionados, 19 estudos foram considerados para leitura do texto completo. Após a leitura do texto completo, 14 estudos preencheram os critérios de elegibilidade. Foram incluídos 12 artigos na meta-análise. Em relação aos sucessos clínicos e radiográficos, não houve diferença significativa entre a pulpotomia com NaOCl e a pulpotomia com formocresol, sulfato férrico, MTA e soro fisiológico. A maioria dos ensaios clínicos randomizados apresentou problemas metodológicos que levaram a uma classificação de médio risco de viés. Todos os ensaios clínicos não randomizados foram classificados com alto risco de viés. Já em relação aos estudos de coorte, todos os dois estudos foram considerados com evidência forte. Conclusão: Os resultados deste estudo apontam que o NaOCl não difere de outros medicamentos como formocresol, sulfato férrico, MTA e soro fisiológico, no sucesso clínico e radiográfico da pulpotomia de dentes decíduos. Rationale/Objectives: Pulpotomy is a conservative pulp therapy that aims to maintain the vitality of the pulp without the need for more radical procedures such as pulpectomy or extraction. The aim of this review was to provide a synthesis of the literature evaluating the clinical and radiographic efficacy of the use of sodium hypochlorite (NaOCl) in pulpotomy of primary teeth and to compare it with other materials used for this procedure. Methodology: Bibliographic searches were performed in Medline via PubMed, Medline via Ovid, Scopus, Lilacs, Embase, Cochrane Library and Web of Sciences. The gray literature search was also performed on Google Scholar, OpenGray, National Institute for Health and Care Excellence (NICE), and ProQuest. Randomized clinical trials, non-randomized clinical trials, and cohort studies in which pulpotomy in primary teeth with sodium hypochlorite was compared with pulpotomy in primary teeth with other materials were included. No restrictions were placed on language or publication date when searching electronic databases. Data were grouped and analyzed descriptively. Qualitative assessment was performed according to the Cochrane risk of bias tool. Rob-2 was used for randomized clinical trials, ROBINS-I for non-randomized clinical trials and the Newcastle-Ottawa Scale for cohort studies. In the RevMan software, meta-analyses were performed incorporating methodologically homogeneous studies. Dichotomous outcomes were used and included clinical and radiographic success. The I2 was used to calculate the heterogeneity of the studies. Results were given in odds ratio and confidence interval. Results: A total of 2654 studies were initially identified through electronic searches. After discarding duplicates and reading the titles and abstracts of the selected articles, 19 studies were considered for reading the full text. After reading the full text, 14 studies met the eligibility criteria. Twelve articles were included in the metaanalysis. Regarding clinical and radiographic successes, there was no significant difference between pulpotomy with NaOCl and pulpotomy with formocresol, ferric sulfate, MTA and saline solution. Most randomized controlled trials had methodological problems that led to a classification of medium risk of bias. All non-randomized clinical trials were classified as having high risk of bias. As for the cohort studies, all two studies were considered to have strong evidence. Conclusion: The results of this study show that NaOCl does not differ from other drugs such as formocresol, ferric sulfate, MTA and saline solution, in the clinical and radiographic success of pulpotomy in primary teeth

Pulpotomy is an alternative of conservative treatment which aims to preserve pulp vitality within root portion, with the aid of biocompatible materials on this remaining living tissue. This study aimed to evaluate the biological response of the pulp remnant to Biodentine® and white Angelus MTA® bioceramic repair cements compared to calcium hydroxide after pulpotomy. Twenty-four male rats had the coronary pulps of the first and second molars exposed and removed with a sharp curette. The remaining pulp tissue received one of the experimental materials: Biodentine®, white Angelus MTA® or Ca(OH)2 + distilled water and sealed with glass ionomer. One group was sealed directly with glass ionomer as a negative control group. After 7 and 15 days, the animals were euthanized and the pieces submitted to histological processing to evaluate the inflammatory process with HE staining and immunohistochemistry (Fibronectin and Tenascin), through the attribution of scores from 1 to 4. Formation of hard tissue bridging was observed in HE staining, evaluating presence, continuity and morphology. Data were submitted to the Kruskal Wallis and Dunn test (p

Objective. To determine the effect of the Croton lechleri lyophilized extract gel on root pulp tissue of pulpotomies performed on Oryctolagus cuniculus. Methods. Thirty-two two-month-old male New Zealand rabbits race, were randomly assigned into four experimental groups: a) control, b) formocresol, c) 1% Croton lechleri and d) 2.5% Croton lechleri. Four pulpotomies were done on each animal. Clinical variables (abscesses, tooth mobility and infections) and histopathological variables (fiber formation, pro-inflammatory cell and regenerative cell number) were analyzed after 1,7,15, and 30 days. Results. No clinical signs were evident in all experimental groups evaluation at any time period. In the first day histopathological evaluation, there were abundant presence of capillaries in all control group samples and half of formocresol ones, while 1% Croton lechleri and 2.5% Croton lechleri groups, had a moderate number in all samples. In the 7,15 and 30 evaluation days, the number of capillaries was higher in formocresol group than the others. The 2.5% Croton lechleri group, showed a lower number of inflammatory cells (macrophages and lymphocytes), a higher number of repair cells (fibroblasts, odontoblasts) and normal collagen fibers than the others, over all evaluated times. Conclusions. The 2.5% Croton lechleri lyophilized extract gel showed a greater anti-inflammatory, healing and regenerating effect on the pulp tissue compared to the other experimental groups., Objetivo. Determinar el efecto del gel del extracto liofilizado de Croton lechleri sobre el tejido pulpar radicular en pulpotomías realizadas en Oryctolagus cuniculus. Métodos. Se utilizaron 32 conejos machos de raza neozelandesa de dos meses de edad que se asignaron aleatoriamente en cuatro grupos de ocho animales: control, formocresol, Croton lechleri 1% y Croton lechleri 2,5%. En cada animal se trabajaron cuatro pulpotomías. Se analizaron variables clínicas (presencia de abscesos, movilidad dentaria e infecciones) e histopatológicas (formación de fibras, cantidad de células proinflamatorias y cantidad de células regenerativas) al cabo de un día, 7, 15, y 30 días. Resultados. En la evaluación clínica, en todos los tiempos evaluados, no se evidenció la existencia de abscesos submucosos, fistula o movilidad dentaria en ninguno de los grupos de tratamiento. En la evaluación histopatológica a 1 día, la presencia de capilares fue abundante en todas las muestras del grupo control y en la mitad de las muestras del grupo formocresol, mientras fue moderada en todas las muestras de los grupos Croton lechleri 1% y 2,5%. A los 7, 15 y 30 días, la presencia de capilares fue mayor en el grupo formocresol. En todos los tiempos evaluados en el grupo Croton lechleri 2,5%, evidenció menor número de células inflamatorias (macrófagos y linfocitos), mayor cantidad de células de reparación (fibroblastos, odontoblastos) y fibras colágenas normales. Conclusiones. El gel del extracto liofilizado de Croton lechleri 2,5% evidenció mayor efecto antiinflamatorio, cicatrizante y regenerador sobre el tejido pulpar en comparación a los otros tratamientos.

The aim of this study was to evaluate the biocompatibility of Biodentine® bioceramic repair cement when compared to White Angelus MTA® and calcium hydroxide. Twenty-four Wistar rats were used (n = 6 animals / group), divided into four experimental periods of 7, 15, 30 and 60 days. The animals received subcutaneous implants of polyethylene tubes containing the 3 test materials and an empty tube used as control. After experimental periods, animals were euthanized and the tubes were removed along with the adjacent surrounding tissue and histologically processed to assess biocompatibility. Inflammatory infiltrate and fibrous capsule thickness were analyzed by HE staining through inflammation scores. Data was submitted to Kruskal Wallis and Dunn’s test (p

Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines. Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo.

O objetivo geral foi avaliar in vitro, em modelos que mimetizem pulpotomias, manchamento e citoxicidade de biomaterais, e apresentar por meio de relato de caso exiquibilidade e sucesso de procedimento endodôntico regenerativo para tratamento de molares jovens. Objetivo 1: Simular fratura coronária complicada em incisivo tratado por pulpotomia total com Bio-C Temp (BC-Angelus) em comparação com dois materiais (MTA Flow–MTA, UltraCal XS-UC; Ultradent), avaliando descoloração dentária, radiopacidade e citotoxicidade nas células pulpares. Objetivo 2: Simular pulpotomia parcial com Bio-C Temp (BC) comparado com Bio-C Repair (BCR-Angelus) e Biodentine (BD-Septodont), avaliando descoloração dentária, radiopacidade, citotoxicidade. Objetivo 3: Relatar acompanhamento de série de casos de revascularização em molares permanentes jovens, com preparo mecanizado de canais radiculares. Nos objetivos 1 e 2, dentes bovinos foram preparados para simular fratura coronária extensa em dente com ápice aberto. As raízes foram preenchidas com mistura de ágar/sangue, e os materiais colocados sobre esta. O grupo controle foi preenchido apenas com ágar/sangue. Análises de avaliação da cor foram realizadas utilizando espectrofotômetro. A mudança total de cor (ΔEab, ΔE00) e índice de brancura (WI) foram calculadas com base no CIELAB. Radiografias digitais foram adquiridas para análise de radiopacidade. Células da polpa humana foram usadas para análise da viabilidade celular. Foram utilizados testes ANOVA e Tukey para comparar os grupos experimentais, e o de Dunnett para comparações com o controle. Nas pulpotomias totais (objetivo 1) todos os materiais foram associados com valores de descoloração maiores do que o aceitável e BT resultou em alteração da cor menor ou semelhante ao MTA e UC, respectivamente. Observou-se redução da radiopacidade apenas no MTA (P=0,007). A viabilidade celular dos materiais foi semelhante à do controle (DMEM) (P>0,05), exceto para BT que teve viabilidade significativamente menor (P0,05). A série de casos descreve técnica de revascularização modificada em molares permanentes jovens. Os pacientes foram submetidos ao preparo manual, seguido de limas rotativas NiTi e pasta de hidróxido de cálcio. Na segunda consulta, a medicação intracanal foi retirada, com irrigação final com EDTA sob agitação ultrassônica e promoção do coágulo. Selamento com MTA e ionômero de vidro e restauração com resina. Após 15 dias, verificou-se ausência de dor, edema e fístula, fechamento do ápice radicular e redução da luz do canal. Basedos nos resultados dos três objetivos concluiu-se que: (1) em pulpotomias totais, BT teve viabilidade celular aceitável, semelhante à do MTA e UC nas diluições mais altas, e BT resultou em menor alteração da cor do que MTA e UC; em pulpotomias parciais BCR apresentou melhores resultados do que BD e BCT, com menor mudança de cor, maior radiopacidade e viabilidade > 80%; os achados da série de casos confirmam que a regeneração endodôntica após preparo mecanizado do canal radicular é uma opção promissora para manutenção de molares permanentes em adolescentes. The general objective was to evaluate in vitro, in models that mimic pulpotomies, staining and cytoxicity of biomaterials, and to present, through a case report, the feasibility and success of a regenerative endodontic procedure for the treatment of young molars. Objective 1: Simulate complicated coronary fracture in an incisor treated by total pulpotomy with Bio-C Temp (BC-Angelus) compared to two materials (MTA Flow – MTA, UltraCal XS-UC; Ultradent), evaluating tooth discoloration, radiopacity and cytotoxicity in pulp cells. Objective 2: Simulate partial pulpotomy with Bio-C Temp (BC) compared with Bio-C Repair (BCR-Angelus) and Biodentine (BD-Septodont), evaluating tooth discoloration, radiopacity, cytotoxicity. Objective 3: To report the follow-up of a series of revascularization cases in young permanent molars, with mechanized preparation of root canals. In objectives 1 and 2, bovine teeth were prepared to simulate extensive coronary fracture in a tooth with an open apex. The roots were filled with an agar / blood mixture, and the materials placed on it. The control group was filled with agar / blood only. Color evaluation analyzes were performed using a spectrophotometer. The total color change (ΔEab, ΔE00) and whiteness index (WI) were calculated based on CIELAB. Digital radiographs were acquired for radiopacity analysis. Human pulp cells were used to analyze cell viability. ANOVA and Tukey tests were used to compare the experimental groups, and Dunnett's for comparisons with the control. In total pulpotomies (objective 1) all materials were associated with discoloration values greater than acceptable and BT resulted in a color change that was less or similar to MTA and UC, respectively. A reduction in radiopacity was observed only in the MTA (P = 0.007). The cell viability of the materials was similar to that of the control (DMEM) (P> 0.05), except for BT which had significantly lower viability (P 0.05). The case series describes a modified revascularization technique in young permanent 11 molars. The patients were submitted to manual preparation, followed by rotating NiTi files and calcium hydroxide paste. In the second consultation, the intracanal medication was removed, with final irrigation with EDTA under ultrasonic agitation and promotion of the clot. Sealing with MTA and glass ionomer and restoration with resin. After 15 days, there was no pain, edema and fistula, closure of the root apex and reduced canal light. Based on the results of the three objectives, it was concluded that: (1) in total pulpotomies, BT had acceptable cell viability, similar to that of MTA and UC at higher dilutions, and BT resulted in less color change than MTA and UC; in partial pulpotomies BCR showed better results than BD and BCT, with less color change, greater radiopacity and viability> 80%; the findings from the case series confirm that endodontic regeneration after mechanized root canal preparation is a promising option for maintaining permanent molars in adolescents. Tese (Doutorado) 2023-04-05