Current trends in the conservative treatment of deep-caries lesion with risk of pulp exposure

Objetivo: apresentar uma revisão da literatura sobre o estado atual da técnica de intervenção mínima e conservação de tecidos duros e vitalidade pulpar em dentes com lesão profunda de cárie e risco de exposição pulpar. Material e Métodos: foram pesquisadas as bases de dados PubMed e SCOPUS, utilizando os descritores cárie dentária em dentina, lesão cariosa profunda e tratamento conservador, entre 1960 e 2018. Resultados: dos 888 artigos inicialmente identificados, 52 foram selecionados após a inclusão e critérios de exclusão. Conclusão: há evidências de que as técnicas conservadoras atuais de escavação gradual e remoção seletiva de cáries impedem a exposição e mantém a vitalidade da polpa, melhorando assim o prognóstico desses dentes. Entretanto, por serem técnicas inovadoras, apesar de apresentarem suporte científico na literatura inglesa, não foram encontrados artigos na língua portuguesa, dificultando o acesso e aumentando o uso dessas técnicas como rotina por dentistas no Brasil.

Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.