sexta-feira, 18 de janeiro de 2008

Curso de Endodontia Maceió :Resumo de artigo sobre MTA (Capeamento direto)

International Endodontic Journal
Volume 41 Issue 2 Page 128-150, February 2008

Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial
Authors: P. N. R. Nair, H. F. Duncan, T. R. Pitt & H. U. Lude

Aim: To investigate the pulpal response to direct pulp capping in healthy human teeth with mineral trioxide aggregate (MTA) as against calcium hydroxide cement (Dycal®) as control.
Methodology :Twenty healthy human third molars had iatrogenic pulpotomy and direct pulp capping with MTA. Another 13 teeth were capped with Dycal® as controls. The teeth were restored, with IRM®, clinically reviewed and extracted after a number of pre-determined intervals (1 week, 1 month and 3 months). The specimens were fixed, decalcified, subdivided axially into two halves in the oro-buccal (lingual–buccal) plane, embedded in plastic, serial sectioned and evaluated qualitatively and quantitatively by correlative light and transmission electron microscopy with appropriate statistical evaluation of the quantitative data.
Results :Iatrogenic pulpal wounds treated with MTA were mostly free from inflammation after 1 week and became covered with a compact, hard tissue barrier of steadily increasing length and thickness within 3 months following capping. Control teeth treated with Dycal® revealed distinctly less consistent formation of a hard tissue barrier that had numerous tunnel defects. The presence of pulpal inflammation up to the longest observation period (3 months) after capping, was a common feature in Dycal® specimens.
Conclusions: The MTA was clinically easier to use as a direct pulp–capping agent and resulted in less pulpal inflammation and more predictable hard tissue barrier formation than Dycal®. Therefore, MTA or equivalent products should be the material of choice for direct pulp capping procedures instead of hard setting calcium hydroxide cements.

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