Efeito antibacteriano e sucesso clínico/radiográfico da pasta de hidróxido de cálcio associada à clorexidina como medicação intracanal no tratamento de dentes decíduos humanos com polpa necrótica
Data
2010-03-05
Autores
Gondim, Juliana Oliveira [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Este trabalho teve como objetivos identificar e quantificar os microrganismos P. gingivalis e E. faecalis no interior dos canais radiculares de dentes decíduos humanos com polpa necrótica, avaliar o efeito do preparo biomecânico dos canais radiculares e da pasta de hidróxido de cálcio com clorexidina usada como curativo intracanal sobre esses microrganismos, bem como, avaliar o sucesso clínico e radiográfico da terapia endodôntica. Foram utilizados 32 dentes com polpa necrótica de 28 pacientes entre 3 e 8 anos de idade. Desses dentes, 12 apresentavam-se sem lesão (Grupo I) e 20 com lesão (Grupo II) na região de furca e/ou periapical vista radiograficamente. Após abertura coronária, foi realizada a primeira coleta microbiológica dos canais radiculares, o preparo biomecânico e a segunda coleta microbiológica. Em seguida, metade dos dentes dos grupos I e II recebeu como curativo intracanal a pasta de hidróxido de cálcio em polietilenoglicol 400 [Ca(OH)2 + PEG] (grupo controle), e a outra metade, a pasta de hidróxido de cálcio com clorexidina gel a 2% [Ca(OH)2+CLX] (grupo experimental). Os dentes foram selados provisoriamente com cimento de ionômero de vidro restaurador. Depois de 30 dias os dentes foram reabertos, o curativo intracanal foi removido e, uma terceira coleta microbiológica foi realizada. Todos os dentes tiveram os canais radiculares obturados com pasta de hidróxido de cálcio em polietilenoglicol 400 e foram restaurados. As amostras microbiológicas foram processadas usando PCR (reação em cadeia da polimerase) em tempo real e os resultados foram avaliados pelos testes de Wilcoxon e de Mann-Whitney (α=0,05). Avaliações clínica e radiográfica foram realizadas nos períodos inicial e de 1, 3 e 6 meses pós-operatório, sendo os resultados comparados pela aplicação...
This study aimed to identify the microorganisms P. gingivalis and E. faecalis in root canals of human deciduous teeth with necrotic pulp, to evaluate the effect of biomechanical preparation of root canals, to evaluate the antibacterial effect of a calcium hydroxide paste prepared with chlorhexidine against these microorganisms, and to evaluate clinical and radiographic success of the endodontic therapy. Thirty two teeth with necrotic pulp of 28 children aged between 3 and 8 years were used. Of these teeth, 12 showed no bone lesions (Group I) and 20 showed radiographic furcation/periapical bone lesions (Group II). After coronal opening and initial microbial root canal sampling, biomechanical preparation and the second microbial sampling were performed. Then, half of the teeth in groups I and II received as intracanal dressing a calcium hydroxide paste in polyethylene glycol 400 [Ca (OH)2 + PEG] (group control), and the other half received calcium hydroxide paste with 2% chlorhexidine gel [Ca (OH)2 + CHX] (experimental group). The teeth were temporarily sealed with a glass ionomer filling material. After 30 days the teeth were reopened, the intracanal dressing was removed and a third microbial sampling was performed. All the teeth had the root canals filled with a calcium hydroxide paste in polyethylene glycol 400 and the final restoration was carried. The microbial samples were processed using real time PCR (polymerase chain reaction) analysis and the results were evaluated by Wilcoxon and Mann-Whitney tests (α=0.05). Clinical and radiographic evaluations were performed at 0, 1, 3 and 6 months postoperatively and the results were compared by the Z statistical test (α=0.05). There was no significant difference between the microbiota present in primary teeth with and without furcation and/or periapical lesions. Biomechanical... (Complete abstract click electronic access below)
This study aimed to identify the microorganisms P. gingivalis and E. faecalis in root canals of human deciduous teeth with necrotic pulp, to evaluate the effect of biomechanical preparation of root canals, to evaluate the antibacterial effect of a calcium hydroxide paste prepared with chlorhexidine against these microorganisms, and to evaluate clinical and radiographic success of the endodontic therapy. Thirty two teeth with necrotic pulp of 28 children aged between 3 and 8 years were used. Of these teeth, 12 showed no bone lesions (Group I) and 20 showed radiographic furcation/periapical bone lesions (Group II). After coronal opening and initial microbial root canal sampling, biomechanical preparation and the second microbial sampling were performed. Then, half of the teeth in groups I and II received as intracanal dressing a calcium hydroxide paste in polyethylene glycol 400 [Ca (OH)2 + PEG] (group control), and the other half received calcium hydroxide paste with 2% chlorhexidine gel [Ca (OH)2 + CHX] (experimental group). The teeth were temporarily sealed with a glass ionomer filling material. After 30 days the teeth were reopened, the intracanal dressing was removed and a third microbial sampling was performed. All the teeth had the root canals filled with a calcium hydroxide paste in polyethylene glycol 400 and the final restoration was carried. The microbial samples were processed using real time PCR (polymerase chain reaction) analysis and the results were evaluated by Wilcoxon and Mann-Whitney tests (α=0.05). Clinical and radiographic evaluations were performed at 0, 1, 3 and 6 months postoperatively and the results were compared by the Z statistical test (α=0.05). There was no significant difference between the microbiota present in primary teeth with and without furcation and/or periapical lesions. Biomechanical... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Clorexidina, Endodontia, Hidroxido de calcio, Dente decíduo, Necrose da polpa dentária, Reação em cadeia da polimerase, Chlorhexidine, Tooth deciduous, Endodontics, Calcium hydroxide, Dental pulp necrosis, Polymerase chain reaction
Como citar
GONDIM, Juliana Oliveira. Efeito antibacteriano e sucesso clínico/radiográfico da pasta de hidróxido de cálcio associada à clorexidina como medicação intracanal no tratamento de dentes decíduos humanos com polpa necrótica. 2010. 88 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Odontologia de Araraquara, 2010.