Genç Daimi Dişlerde MTA ile Koronal Pulpotomi: Vaka Serisi

Yıl 2024, Sayı: 3, 116 - 124, 15.10.2024

Menekşe Alim , Mehmet Bani

https://doi.org/10.51122/neudentj.2024.122

Öz

Vital pulpa tedavisi travma, çürük veya restoratif prosedürler sebebiyle hasar alan pulpanın, canlılığını ve işlevini korumanın bir yoludur. Vital pulpa tedavisi prosedürleri; direkt kuafaj, indirekt kuafaj, hastalıklı pulpa dokusunun çıkarıldığı parsiyel ve koronal pulpotomi tedavilerini içermektedir. Yıllar boyunca vital pulpa tedavisinin odak noktası, kök oluşumunun (apeksogenez) tamamlanmasını sağlamak için gelişimini tamamlamamış daimi dişlerde radiküler pulpanın korunması olmuştur. Günümüzde ise vital pulpa tedavisinin, belirli şartlara sahip geri dönüşümsüz olarak inflame pulpaya sahip olduğu düşünülen dişler de dahil olmak üzere, kök kanal tedavisine alternatif olarak değerlendirilebileceği bildirilmiştir. Vital pulpa tedavilerinden olan koronal amputasyon tedavisi koronal pulpanın tamamen çıkarılması, biyolojik olarak kabul edilebilir bir materyalin pulpa odasına yerleştirilmesi ve restorasyonunu içerir. Kaplama materyali ise, pulpa dokusundaki inflamasyonu giderip iyileşmeyi başlatabilmeli ve yeni dentin dokusunun oluşabilmesini sağlamalıdır. Pulpotomide kullanılan en eski materyal kalsiyum hidroksittir. Daha güncel bir materyal olan mineral trioksit agregatı ise biyouyumlu ve biyoaktif özellikleri nedeniyle günümüzde sıklıkla tercih edilmektedir. Bu olgu raporunda genç daimi dişlerde mineral trioksit agregatı ile koronal pulpotomi uygulanan 4 olgunun 18 ay takipli tedavi sonuçları sunulmuştur.

Anahtar Kelimeler

Pulpotomi, Vital pulpa tedavisi, Genç daimi diş

Total Pulpotomy with MTA in Young Permanent Teeth: Case Series

Öz

Vital pulp therapy is a way to preserve the vitality and function of pulp damaged by trauma, caries or restorative procedures. Vital pulp therapy procedures include direct pulp capping, indirect pulp capping, partial and coronal pulpotomy treatments where diseased pulp tissue is removed. Over the years, the focus of vital pulp therapy has been on the preservation of the radicular pulp in immature permanent teeth to ensure the completion of root formation (apexogenesis). Today, it has been reported that vital pulp therapy can be considered as an alternative to root canal treatment, including in teeth with certain conditions that are considered to have irreversibly inflamed pulp. Coronal amputation therapy, a vital pulp treatment, involves complete removal of the coronal pulp, placement of a biologically acceptable material into the pulp chamber and restoration. The covering material must be able to relieve inflammation and initiate healing of the pulp tissue and allow new dentin tissue to form. The oldest material used in pulpotomy is calcium hydroxide. Mineral trioxide aggregate, which is a more recent material, is frequently preferred today due to its biocompatible and bioactive properties. In this case report, the results of 4 cases of coronal pulpotomy with mineral trioxide aggregate in young permanent teeth with a follow-up of 18 months are presented.

Anahtar Kelimeler

Pulpotomy, Vital pulp therapy, Young permanent teeth

Kaynakça

• Innes N, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016;28:49-57.
• Careddu R and Duncan HF. A prospective clinical study investigating the effectiveness of partial pulpotomy after relating preoperative symptoms to a new and established classification of pulpitis. Int Endod J. 2021;54:2156-72.
• Zhang W, and Yelick PC. Vital pulp therapy-current progress of dental pulp regeneration and revascularization. Int J Dent. 2010:856087.
• Owatz CB, Khan AA, Schindler WG, Schwartz SA, Keiser K, and Hargreaves KM. The incidence of mechanical allodynia in patients with irreversible pulpitis. J Endod. 2007;33:552-6.
• Chen E, and Abbott PV. Dental pulp testing: a review. Int J Dent. 2009:365785.
• Baume LJ. Diagnosis of diseases of the pulp. Oral Surg Oral Med, Oral Pathol. 1970;29:102- 16.
• Dummer PMH, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J. 1980;13:27-35.
• Rechenberg DK, Zehnder M. Call for a review of diagnostic nomenclature and terminology used in endodontics. Int Endod J. 2020;53:1315-17.
• Ricucci D, Siqueira Jr JF, Li Y, Tay FR. Vital pulp therapy: histopathology and histobacteriologybased guidelines to treat teeth with deep caries and pulp exposure. J Dent. 2019;86:41-52.
• Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M et al. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J. 2017;50:825-9.
• Bogen G, Dammaschke T, Chandler N. Vital pulp therapy. In: Berman L, Hargreaves KM, editors. Pathways of the pulp. 12th ed. St. Louis, MO: Elsevier; 2021.
• Lin LM, Ricucci D, Saoud TM, Sigurdsson A, Kahler, B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Aust Endod J. 2020;46:154-65.
• Leong DJX, Yap AU. Vital pulp therapy in carious pulp–exposed permanent teeth: an umbrella review. Clin Oral Investig. 2021;25:6743-56.
• Li Y, Sui B, Dahl C, Bergeron B, Shipman P, Niu L, Chen J, and Tay FR. Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis. J Dent. 2019; 84: 1-8.
• Camoni N, Cagetti MG, Cirio S, Esteves-Oliveira M, Campus G. Partial pulpotomy in young permanent teeth: A systematic review and meta-analysis. Children. 2023;10:55-8.
• El Meligy OA, Avery DR. Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis). Pediatr Dent. 2006;28:399-404.
• Simon S, Perard M, Zanini M, Smith AJ, Charpentier E, Djole SX, Lumley PJ. Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts. Int End J. 2013;46:79-87.
• Ghoddusi J, Shahrami F, Alizadeh M, Kianoush K, Forghani M. Clinical and radiographic evaluation of vital pulp therapy in open apex teeth with MTA and ZOE. N Y State Dent J. 2012;78:34-8.
• Alqaderi HE, Al-Mutawa SA, Qudeimat MA. MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting. J Dent. 2014;42:1390-5.
• Qudeimat MA, Alyahya A, Hasan AA, and Barrieshi-Nusair KM. Mineral trioxide aggregate pulpotomy for permanent molars with clinical signs indicative of irreversible pulpitis: a preliminary study. Int Endod J. 2017;50:126-34.
• Elmas S, Kotan DA, and Odabaş ME. Two-year outcomes of coronal pulpotomy in young permanent molars with clinical signs indicative of irreversible pulpitis. Pediatr Dent. 2023;45:46-52.
• Barngkgei IH, Halboub ES, Alboni RS. Pulpotomy of symptomatic permanent teeth with carious exposure using mineral trioxide aggregate. Iran Endod J. 2013;8:65-8.
• Duncan H, Galler K, Tomson P, Simon S, El‐Karim I, Kundzina R, et al. European Society of Endodontology position statement: Management of deep caries and the exposed pulp. Int End J. 2019;52:923-34.
• American Association of Endodontists. AAE position statement on vital pulp therapy. Erişim tarihi: 01.06.2024, https://www.aae.org/wp-content/uploads/2021/05/VitalPulpTherapyPo sitionStatement_v2.pdf.
• Mobarak A, Genena S, Zaazou A, Mokhless NA, Moussa SM. Regenerative pulpotomy as a novel technique for treatment of permanent mature molars diagnosed with irreversible pulpitis using platelet-rich fibrin: a case series study. Alex Dent J. 2021;46:129-35.
• Ather A, Patel B, Gelfond JA, and Ruparel NB. Outcome of pulpotomy in permanent teeth with irreversible pulpitis: a systematic review and meta-analysis. Sci Rep. 2022;12:19664.
• Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: A systematic review. J Dent. 2011;37:581-7.
• Zanini M, Hennequin M, Cousson PY. A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth. J Endod. 2016;42:1167-74.
• Duncan HF, El‐Karim I, Dummer PM, Whitworth J, Nagendrababu V. Factors that influence the outcome of pulpotomy in permanent teeth. Int Endod J. 2023;56:62-81.
• Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J. 2018;8:819-28.
• Galani M, Tewari S, Sangwan P, Mittal S, Kumar V, Duhan J. Comparative evaluation of postoperative pain and success rate after pulpotomy and root canal treatment in cariously exposed mature permanent molars: A randomized controlled trial. J Endod. 2017;43:1953-62.
• Hafez AA, Cox CF, Tarim B, Otsuki M, Akimoto N. An in vivo evaluation of haemorrhage control using sodium hypochlorite and direct capping with a one-or two-component adhesive system in exposed nonhuman primate pulps. Quintessence Int. 2002;33:261-72.
• Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, and Roig M. Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs. J Endod. 2012;38:1588-91.
• Taha NA, and Abdulkhader SZ. Full pulpotomy with biodentine in symptomatic young permanent teeth with carious exposure. J Endod. 2018;44:932-7.
• Qudeimat M, Alyahya A, Hasan A, and Barrieshi‐Nusair K. (2017). Mineral trioxide aggregate pulpotomy for permanent molars with clinical signs indicative of irreversible pulpitis: a preliminary study. Int Endod J. 2017;50:126-34.
• Chen Y, Chen X, Zhang Y, Zhou F, Deng J, Zou J, Wang Y. (2019). Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis. BMC Oral Health. 2019;19:227.
• Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview - part i: Vital pulp therapy. Int Endod J. 2018;51:177-205.
• Dawood AE, Parashos P, Wong RHK, Reynolds EC, Manton DJ. Calcium silicate-based cements: Composition, properties, and clinical applications. J Investig Clin Dent. 2017;8:e12195.
• Cho SY, Seo DG, Lee SJ, Lee J, Lee SJ, Jung IY. Prognostic factors for clinical outcomes according to time after direct pulp capping. J Endod. 2013;39:327-31.