O tratamento endodôntico em dentes com rizogênese incompleta

Abstract

As soon as the eruption of permanent teeth occurs, until occlusion with their opposite teeth happens and they start to receive occlusive masticatory forces, the process of root formation is being completed. This phase corresponds to childhood and teenage from our patients whom are prone to suffer traumatic injuries or caries lesions. The objective of this study was to present and discuss the factors related to conservative and non conservative endodontic treatment, aiming apexogenesis or apexification in permanent immature teeth whose pulp has suffered irreversible inflammatory changes or necrosis. A correct diagnosis of pulp condition is crucial to establish the best possible treatment. A few scientific articles that discuss conservative endodontic treatment by the conduction of pulpotomies shows that it can be the choice of treatment in immature teeth with reversible pulpitis for its skill to encourage the fisiological root development (apexogenesis). However, it is necessary to be cautious when indicating pulpotomies as a routine clinical procedure. The apexification techniques aiming the formation of an apical barrier are based on endodontic treatment with calcium hydroxide or/and MTA (Mineral Trioxide Aggregate). Different studies were presented to compare these techniques. Each one of them have its advantages and risks but can be done sucessfully, as demonstrated by researchers who applied them. Regenerative endodontic approaches using stem cells and revascularization have been introduced but still being used experimentally and need better results and methods to be safely indicated for dentistry clinical practice.