Ionic concentration in periradicular medium after dissolution of endodontic file fragments: an in vitro study

Abstract The aim of this study was to obtain ionic quantification in periradicular medium after diffusion tests of the solution used inside root canals during the electrochemical dissolution of endodontic file fragments and the NiTi-containing dissolution product via an apical foramen. Thirty single-rooted extracted human teeth had root canals prepared and were attached to Eppendorf tubes filled with sterile saline. The samples were divided into 3 groups (n = 10) according to the solution used inside the root canal during the diffusion tests: Group 1: [NaF 12 g/L + NaCl 1 g/L]; Group 2: [NaF 12 g/L + NaCl 1 g/L + NiTi 0.50 g/L]; Group 3: [NaF 6 g/L + NaCl 0.5 g/L + NiTi 0.25 g/L]. The sample in each Eppendorf tube was then analyzed to assay the ionic quantification in periradicular medium. The groups were compared in relation to ionic quantifications (Kruskal-Wallis and Dunn's tests, p ≤ 0.05). Group 2 showed significantly higher F-, Ni and Ti quantities than groups 1 and 3 (p < 0.05). Group 3 showed significantly higher Ti and Ni quantities than group 1, where no measurable quantities of Ti and Ni were observed (p < 0.05). The conclusions were that a 50% dilution of the NiTi-containing dissolution product resulted in significantly lower F-, Ni and Ti quantities compared to the undiluted product. The quantifications observed here suggest that irrigation is recommendable during the electrochemical dissolution process to reduce the resultant ion concentrations in both the root canal and the periradicular medium.

Apical debris extrusion during instrumentation with continuous and reciprocating systems

Objective: to evaluate the amount of apical debris extrusion during root canal preparation using continuous and reciprocating systems. Material and Methods: Forty lower incisors were selected and randomly divided into four groups (n=10) for root canal preparation. Two multifile systems with continuous rotation (iRace® and Mtwo®) and two reciprocating single-file systems (Reciproc® and WaveOne®) were used. In the iRace® group, the R1 (15/.06), R2 (25/.04) and R3 (30/.04) instruments were used. In the Mtwo® group, the 10/.04, 15/.05, 20/.06, and 25/.06 instruments were used. In the Reciproc® and WaveOne® groups, the R25 and 25/.04 instruments were used, respectively. Apical debris extrusion was determined by calculating the difference between the pre- and post-instrumentation weight of the Eppendorf tubes. Statistical analysis was performed using the analysis of variance (ANOVA) test with the Bonferroni correction (p<0.05). Results: The iRace® group demonstrated significantly more apical extrusion than the Reciproc® group (p<0.05). There was no statistically significant difference between the Mtwo®, Reciproc®, and WaveOne® groups (p>0.05). Conclusion: All of the evaluated systems produced apical debris extrusion. The iRace® system produced more apical debris extrusion than the Reciproc® system, and there was no difference observed in this regard between the Mtwo®, Reciproc®, and WaveOne® systems.

Objetivo: avaliar a quantidade de debris extruidos apicalmente durante o preparo do canal radicular usando sistemas de rotação contínua e reciprocante. Materiais e Métodos: Quarenta incisivos inferiores foram selecionados e randomicamente divididos em quatro grupos (n=10) para o preparo do canal radicular. Dois sistemas de limas múltiplas de rotação contínua (iRace® e Mtwo®) e dois sistemas de limas únicas reciprocantes (Reciproc® e WaveOne®) foram usados. No grupo iRace®, foram utilizados os instrumentos R1 (15/.06), R2 (25/.04) e R3 (30/.04). No grupo Mtwo®, foram utilizados os instrumentos 10/.04, 15/.05, 20/.06, 25/.06. Nos grupos Reciproc® e WaveOne®, foram utilizados os instrumentos R25 e 25.04, respectivamente. A extrusão apical de debris foi calculada pela diferença entre os pesos dos tubos Eppendorf antes e após a instrumentação. A análise estatística foi feita usando o teste de análise de variância (ANOVA) seguida do teste de Bonferroni (p<0,05). Resultados: O grupo iRace® demonstrou significativamente mais extrusão quando comparado ao Reciproc (p<0,05). Não houve diferença estatisticamente significativa entre os grupos Mtwo®, Reciproc®, e WaveOne® (p>0,05). Conclusão: Todos os sistemas avaliados produziram extrusão apical de debris. O Sistema iRace® produziu mais extrusão apical de debris do que o Sistema Reciproc® e não foi observada diferença entre os sistemas Mtwo®, Reciproc® e WaveOne®.

Replantation of avulsed tooth: a step-by-step report

Introduction: Avulsion is a serious injury that causes damage to dental and supportive tissues, and is characterized by complete displacement of a tooth from its socket. In most situations, replantation is the treatment of choice for permanent tooth avulsion, and appropriate management is critical for a good prognosis in these cases. Previous studies have shown that the level of knowledge of dentists regarding the management of an avulsed tooth is deficient and have underscored the importance of continuing dental education to further the knowledge of general dentists in the urgency management of permanent avulsed teeth. Objective: This report aims to present a step-by-step clinical sequence involving the reimplantation of a mature permanent tooth that suffered avulsion,following the CARE guide. Case report: Tooth 21, stored in milk, was reimplanted 2 hours after avulsion and stabilized with flexible containment. The clinical steps were carried out according to the recommendations of the International Association of Dental Traumatology. Endodontic treatment was started five days after reimplantation, with periodic changes of intracanal medication. The patientis currently under follow-up, with no negative signs or symptoms related to avulsion. Conclusion: Dental reimplantation after avulsion should be performed after a thorough systemic and oral diagnosis and tooth storage conditions, with a clinical protocol based on scientific evidence of associations of dentoalveolar trauma.

Introdução: A avulsão é uma injuria grave que causa sérios danos aos tecidos de suporte do doente e é caracterizada pelo completo deslocamento do elemento dentário de dentro do alvéolo. O reimplante é, na maioria das situações, o tratamento de escolha para o dente permanente avulsionado e uma conduta correta é necessária para um bom prognostico nestes casos. Estudos prévios mostram que o conhecimento de dentistas sobre o manejo de um dente que sofreu avulsão é deficiente e destacam a importância da educação continuada, com a intenção de aumentar o nível de conhecimento de dentistas clínicos frente a urgências envolvendo dentes avulsionados. Objetivo: este relato tem como objetivo apresentar uma sequência clínica passo-a-passo envolvendo o reimplante de um dente permanente maduro que sofreu avulsão, seguindo o guia CARE. Relato do caso: O dente 21, armazenado em leite, foi reimplantado 2 horas após a avulsão e estabilizado com contenção flexível. As etapas clínicas foram realizadas conforme as recomendações da Associação Internacional de Traumatismos Dentários. O tratamento endodôntico foi iniciado cinco dias após o reimplante, com trocas periódicas de medicação intracanal. Atualmente o paciente encontra-se em acompanhamento, sem sinais ou sintomas negativos relacionados a avulsão. Conclusão: O reimplante dental após avulsão deve ser realizado após minucioso diagnóstico e condições de armazenamento do dente, com protocolo clínico embasado nas evidências científicas das associações de traumatismos dentoalveolares.

Extrusão apical de debris após o uso de um instrumento reciprocante e uso suplementar de instrumento com liga MaxWire / Apically Extruded Debris Using Reciprocating Single File and Additional Use of MaxWire Allow File

Objetivo: O objetivo deste estudo foi avaliar a quantidade de debris extruídos apicalmente após o preparo do canal com o WaveOne Gold e o uso suplementar do instrumento XP-Endo Finisher. Material e Métodos: Quarenta pré-molares humanos com canal único foram selecionados e divididos em dois grupos (n = 20): preparo com instrumento WaveOne Gold e preparo com instrumento WaveOne Gold + XP-Endo Finisher. Os canais radiculares foram instrumentados seguindo as instruções do fabricante e a água destilada foi usada como irrigante. Debris extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pesados previamente em balança analítico. O peso dos detritos extruídos foi estabelecido subtraindo-se o peso pré-instrumentação e pós-instrumentação dos tubos Eppendorf para cada grupo. Resultados: Os dados foram analisados pelos testes de Shapiro-Wilk e Mann-Whitney, com nível de significância de 5%. Não houve diferença significativa entre os grupos (p = 0,66) em relação à quantidade debris extruídos apicalmente. Conclusão: A presença de debris extruídos apicalmente ocorreu nos dois grupos; no entanto, o uso adicional do instrumento XP-Endo Finisher não contribuiu para o aumento significativo da extrusão apical de detritos quando comparado ao uso isolado do instrumento WaveOne Gold.

Objective: the aim of this study was to evaluate the amount of apically extruded debris after the preparation with WaveOne Gold and additional use of XP-Endo Finisher file. Material and Methods: Forty human one-rooted premolars were selected and divided into two groups (n=20): WaveOne Gold and WaveOne Gold and XP-Endo finisher. Subsequently, the root canals were instrumented following the manufacturer's instructions and distilled water was used as irrigant. Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and postinstrumentation weight of the Eppendorf tubes for each group. Results: The data were analyzed using Shapiro-Wilk and Mann-Whitney tests, with significant level of 5%. There was no significant difference between groups (p=0.66) in relation to apically extruded debris. Conclusion: apically extruded debris occurred in both groups; however, the additional use of the XP-Endo Finisher instrument did not contribute to the significant increase of apical extrusion of debris when compared to the isolated use of WaveOne Gold

Risk Factors for Different Types of Traumatic Injuries in Primary Teeth

Abstract Objective: To evaluate traumatic dental injuries (TDI) in primary teeth and the association of gender and age with different injuries. Material and Methods: Records of patients with TDI in primary teeth were included. The following parameters were registered: gender and age, place of trauma, cause of trauma, affected tissue and tooth, number of injured teeth, type of injury, and gingival and bone damage. A logistic regression analysis was performed to explore the interaction between gender and age on the occurrence of types of injuries (p≤0.05). Results: The total of 721 records were evaluated and 370 records were included, being 61.6% boys and 60.5% children aged 0-3 years old, with 658 primary teeth affected. The support tissue was most affected (496/658), followed by dental tissue (139/658). Enamel/dentine fracture with pulp exposure (n=51) and intrusion (n=131) were the most common injuries of dental and support tissues, respectively. In general, boys suffered more traumas than girls, regardless of the age range. As for concussion, logistic regression confirms that gender and age are also influencers. Girls (OR=1.822, CI = 1.050-3.164, p=0.033) in the 4-6 year age group (OR=2.15, CI = 1.239-3.747, p=0.007) are more likely to have concussions. Children age 4-6 years were less likely to suffer an intrusion (OR=0.496; CI = 0.278-0.886; p=0.018). Conclusion: Gender and age influence concussion and intrusion in the primary teeth.

Complicated crown fracture treatment and its impact on quality of life related to oral health: report of two cases

Objective: The purpose of this study was to report on the management of two complicated crown fractures of the permanent incisors and how the treatment of these injuries influences quality of life related to oral health (QHRQoL). Case report : In the first case, pulpectomy was performed because of pulp necrosis and complete rhizogenesis. In the second case, pulpotomy was performed, as the pulp had vitality and the tooth had incomplete rhizogenesis. Fragment bonding was carried out in both cases. QHRQoL was assessed before and one week after treatment. In case 1, scores varied from 32 to 9 in the CPQ 11-14, from 42 to 12 in the P-CPQ, and from 24 to 4 in the FIS. In case 2, scores varied from 38 to 20 in the CPQ 8-10 , from 94 to 28 in the P-CPQ, and from 39 to 10 in the FIS. Conclusion : Fragment bonding is an efficient solution, as well as endodontic therapy. Furthermore, dental trauma treatment improved the quality of life of children and their families and could be observed one week after treatment.

Objetivo: O objetivo do estudo foi relatar o manejo de duas fraturas complicadas de incisivos permanentes e como o tratamento destas lesões dentárias influencia a qualidade de vida relacionada à saúde bucal (QHRQoL). Relato de caso: No primeiro caso, foi realizada pulpectomia devido necrose pulpar e rizogênese completa. No segundo caso, a pulpotomia foi realizada, pois, a polpa apresentava vitalidade e o dente rizogênese incompleta. A colagem dos fragmentos foi realizada emambos os casos. QHRQoL foi avaliada antes e uma semana após o tratamento. No caso 1, os escores variaram de 32 a 9 no CPQ 11-14 , de 42 a 12 no P-CPQ e de 24 a 4 no FIS. No caso 2, os escores variaram de 38 a 20 no CPQ 8-10 , de 94 a 28 no P- CPQ e de 39 a 10 no FIS. Conclusã : A colagem de fragmentos é uma solução eficiente, assim como a terapia endodôntica. Além disso o tratamento do traumatismo dentário promoveu uma melhora na qualidade de vida das crianças e suas famílias, e podendo ser observado uma semana após o tratamento.

Accuracy of the initial diameter of finishing files and Gutta-Percha cones of the protaper Universal System

Objective: to assess the accuracy of the nominal initial diameter of ProTaper Universal® finishing files and their respective gutta-percha cones. Method : ProTaper Universal® finishing files, F1, F2, F3, F4 and F5 and corresponding ProTaper cones were used (10 of each). A Profile Projector was used to evaluate the initial diameter of files and cones. All measurements were repeated twice and performed by a single trained operator. A descriptive analysis of the files' initial diameters was performed considering the tolerance limit established by the ADA number 101. According to this standard, the files F1, F2 and F3 have a tolerance limit of ± 0.025 mm and the files F4 and F5 ± 0.05 mm. The same tolerance limit was used to evaluate the cones. The initial diameters of the instruments and cones studied were compared with the nominal values given by the manufacturer through Student's T test (pd"0.05). Results: No finishing file group showed adequate accuracy (pd"0.05). Accuracy was verified only from the F5 ProTaper cone group (p> 0.05). It was verified that 30% (n=15) of the finishing files and 20% (n = 10) of the cones exceeded the tolerance limits. Conclusion : Accuracy was not observed for any file and it was identified only in the F5 ProTaper Universal® cone. Most files and cones were within the tolerance limits established by the ADA.

Objetivo: Analisar a acurácia do diâmetro inicial dos instrumentos de acabamento do sistema ProTaper Universal® e seus respectivos cones de guta-percha. Método: Foram utilizados instrumentos de acabamento do sistema ProTaper Universal® F1, F2, F3, F4 e F5 e cones de guta-percha ProTaper correspondentes (10 de cada). O projetor de perfil foi usado para avaliar o diâmetro inicial dos instrumentos e cones. Todas as medições foram feitas duas vezes por um único operador treinado. Uma análise descritiva do diâmetro inicial dos instrumentos foi realizada considerando o limite de tolerância proposto pela ADA número 101. De acordo com essa norma, os instrumentos F1, F2 e F3 tem um limite de tolerância de ± 0.025 mm e os instrumentos F4 e F5 ± 0.05 mm. O mesmo limite de tolerância foi utilizado para avaliar os cones. Os diâmetros iniciais dos instrumentos e cones estudados foram comparados com os valores nominais dados pelo fabricante através do teste T (pd"0.05). Resultados: Foi verificada acurácia somente do cone de guta-percha ProTaper do grupo F5 (p>0,05). Nenhum grupo de instrumento de acabamento apresentou acurácia (pd"0,05). Foi verificado que 30% (n=15) dos instrumentos de acabamento e 20% (n=10) dos cones excederam o limite de tolerância. Conclusão: Acurácia não foi verificada em nenhum instrumento ProTaper Universal® e somente o cone F5 apresentou acurácia. A maioria dos instrumentos e cones estavam dentro do limite de tolerância proposto pela ADA.

Knowledge of paediatric patients and their guardians about mouth guards

Introduction: Mouth guards are devices used to prevent injuries during sports activities. Objective: The aim of this study is to evaluate the knowledge of paediatric patients and their guardians about mouth guards. Methods: Paediatric patients from 9 to 15 years old and their guardians who sought care in the Paediatric Clinic of the Dentistry School were invited to participate. Their knowledge about mouth guards was collected through a two-part questionnaire with open and closed ended questions. The first part of the questionnaire contained sociodemographic questions and a main question about what a mouth guard is. The second part was solely about mouth guards and was applied immediately after an explanation about mouth guards at the end of the first part. All data collected were tabulated and analysed descriptively. Results: A total of 122 guardians were interviewed; 39.3% had children who practised some type of sports activity and 32% reported a trauma episode. Most (54.9%) did not know what a mouth guard was but, after explanation, 57.4% had seen someone using one. A total of 33 paediatric patients were interviewed, 60.6% of whom practised some sport; 27.3% of these had already suffered some type of dental trauma during the activity. None of the interviewees used a mouth guard during their sports activity, although 97% believed that using a mouth guard was important and 78.8% believed that the protector did not interfere with the activity. Conclusion: Guardians and paediatric patients have little knowledge about mouth guards.

Introdução: Os protetores bucais são usados para prevenir lesões durante atividades esportivas. Objetivo: O objetivo deste estudo é avaliar o conhecimento sobre os protetores bucais dos pacientes pediátricos e seus responsáveis. Métodos: Pacientes pediátricos de 9 a 15 anos, que procuraram atendimento na Clínica Pediátrica da Faculdade de Odontologia e seus responsáveis foram convidados a participar. Seu conhecimento sobre protetores bucais foi coletado através de um questionário em duas partes com perguntas abertas e fechadas. A primeira parte do questionário continha algumas questões sociodemográficas e uma questão principal sobre o que é um protetores bucais. A segunda parte era apenas sobre protetores bucais e foi aplicada imediatamente após uma explicação sobre os protetores bucais no final da primeira parte. Todos os dados coletados foram tabulados e analisados de forma descritiva. Resultado: Um total de 122 guardiões foram entrevistados, 39.3% tiveram crianças que praticavam algum tipo de atividade esportiva e 32% relataram um episódio de trauma. A maioria (54.9%) não sabia o que é um protetor bucal, mas após a explicação, 57.4% tinham visto alguém usando um. Um total de 33 pacientes pediátricos foram entrevistados, 60.6% praticaram algum esporte e 27.3% deles já sofreram algum tipo de trauma dental durante a atividade. Nenhum dos entrevistados usa um protetor bucal durante a atividade esportiva, embora 97% acreditem que usar um protetor bucal é importante e 78.8% acreditam que o protetor não interfere com a atividade. Conclusão: Em conclusão, os guardiões e pacientes pediátricos têm pouco conhecimento sobre os protetores bucais.

Abordagem multidisciplinar no tratamento de um paciente pediátrico com traumatismo dentário / Multidisciplinary approach to treat a pediatric patient with dental trauma

Objetivou-se relatar uma abordagem multidisciplinar na reabilitação funcional e estética após traumatismo dentário em um pacientepediátrico. Um paciente do sexo masculino, 9 anos de idade, apresentou-se com fratura coronária complexa do elemento 21 e impactação do elemento 11 devido a presença de odontoma. No elemento 11, após a remoção do odontoma foi observado a sua erupção espontânea restabelecendo sua estética e função. No elemento 21, o paciente recebeu um tratamento multidisciplinar, no qual realizou-se: aumento de coroa clínica, tracionamento ortodôntico, tratamento endodôntico, cimentação de retentor intrarradicular e restauração estética. As abordagens multidisciplinares são componentes importantes para o sucesso da reabilitação funcional e estética de complexas fraturas coronárias.

The objective was to report a multidisciplinary approach in the functional and esthetic rehabilitation after dental trauma in apediatric patient. A male patient, 9 years old, presented with a complex crown fracture of the element 21 and 11 impaction of the element due to the presence of odontoma. In element 11, after the removal of odontoma was found at his spontaneous eruption restoring its function and aesthetics. In element 21, the patient received a multidisciplinary treatment, following: an increase in clinical crown, orthodontic traction, endodontic treatment, cement retainer intraradicular and aesthetic restoration. Multidisciplinary approaches are important components for successful rehabilitation of complex functional and aesthetic crown fractures.

Efeito antibacteriano dos lasers e terapia fotodinâmica contra Enterococcus faecalis no sistema de canais radiculares / Antibacterial effect of the lasers and photodynamic therapy against Enterococcus faecalis in the root canal system

O preparo químico-mecânico (PQM) é crucial para o sucesso do tratamento endodôntico. Neste sentido, metodologias são desenvolvidas a fim de garantir a máxima desinfecção do sistema de canais radiculares. Assim, o objetivo desta revisão de literatura foi avaliar a capacidade dos lasers e da terapia fotodinâmica (PDT) em eliminar o Enterococcus faecalis, fortemente associado ao fracasso da terapia endodôntica. A busca pelos artigos foi realizada de duas formas: por meio dos guias de estudo on line do Journal of Endodontics e por meio das bases de dados: BBO, PUBMED/MEDLINE e OVID. Paralelamente, foi realizada busca cruzada, considerando as referências bibliográficas dos artigos selecionados. Os critérios de inclusão foram: a) os períodos de tempo entre abril de 2000 e fevereiro de 2010; b) artigos que avaliassem o efeito antimicrobiano dos lasers e PDT sobre o E. faecalis. Após a leitura completa dos artigos selecionados, incluíram-se: 15 artigos que avaliaram a capacidade antibacteriana do laser, 10 artigos relativos à PDT e 5 artigos que compararam o laser e a PDT. Baseado nesta revisão, concluiu-se que nenhuma das duas técnicas foi 100% eficaz contra o E. faecalis, mas que foram capazes de reduzir sua presença; a PDT se mostrou aparentemente mais eficaz que o laser no controle desta infecção. Desta forma, as terapias podem ser consideradas aliadas promissoras ao tratamento convencional no controle da infecção endodôntica por E. faecalis, caracterizando-se como terapias complementares.

The chemomechanical disinfection is crucial to the success of endodontic treatment. In this regard, methodologies are developed to ensure maximum disinfection of root canal system. The objective of this literature review was to evaluate the ability of lasers and photodynamic therapy (PDT) in eliminating Enterococcus faecalis, which is strongly associated with failure of endodontic therapy. The search for articles was performed in two ways: through the online study guides in the Journal of Endodontics and, through databases: BBO, PubMed/MEDLINE and OVID. In parallel, we performed cross-searching, given the references of selected articles. Inclusion criteria were: a) the time periods between April 2000 and February 2010; b) articles that evaluate antimicrobial effect of lasers and PDT on E. faecalis. After a complete reading of selected articles, were included: 15 articles that evaluated the antibacterial capacity of the laser, 10 of PDT and 5 that compared laser and PDT. Based on this review, concluded that: neither of the two techniques was 100% effective against E. faecalis, but were able to reduce their presence; PDT apparently showed more effective than laser in controlling this infection. Thus, therapies can be considered promising allied to conventional treatment in the control of endodontic infection by E. faecalis, which is characterized as complementary therapies.

Epidemiologic survey of traumatic dental injuries in children seen at the Federal University of Rio de Janeiro, Brazil

This epidemiologic survey aimed at assessing the prevalence of traumatic dental injuries in children seen at the Federal University of Rio de Janeiro, Brazil. The records of a total of 111 children (aged 0 to 6 years) seen from 2004 to 2006 in the dental trauma clinic were surveyed, comprising a total of 201 traumatized primary teeth. Data pertaining to the child and to the trauma such as age, gender, etiology, teeth involved, type of traumatic injury, time elapsed between the trauma and seeking care, and the presence and kind of clinical and radiographic sequelae in the first visit were collected from the dental records. All variables studied were assessed by means of frequency analysis and the Chi-square test (p < 0.05). A higher prevalence of trauma was observed in boys (56.7 percent) and in the age group from 0-3 years (73.8 percent). The most affected teeth were the central incisors (84.7 percent) and the most common trauma etiology was a fall from the child's own height (63.0 percent). The supporting tissues were the most affected. Lateral luxation was the most frequent alteration observed (33.4 percent), followed by concussion (21.0 percent). Coronal discoloration (17.7 percent) and external resorption (18.3 percent) were, respectively, the most prevalent clinical and radiographic sequelae. Gender had no influence on the clinical (p = 0.54) and radiographic (p = 0.55) sequelae. Even though age had no influence on radiographic sequelae (p = 0.41), clinical sequelae were more prevalent in children aged 0 to 3 years (p = 0.03). In conclusion, traumatisms in primary teeth were more prevalent in boys, and in 0-3-year-old children. Luxation was the most frequent traumatic lesion, and coronal discoloration and external resorption were the most prevalent sequelae.

Proteção pulpar direta com agregado trióxido mineral (MTA) em molar decíduo com agenesia do sucessor permanente / Direct pulp protection with mineral trioxide aggregate (MTA) in a primary molar with successor permanent agenesis

A manutenção do elemento decíduo na arcada tem fundamental importância no estabelecimento de uma oclusão normal, principalmente em casos de agenesia dental. A proteção pulpar direta é um tratamento conservador que visa à manutenção da vitalidade pulpar e possibilita a permanência do elemento dental na arcada. Um material recentemente utilizado é o Agregado Trióxido Mineral, devido às suas propriedades favoráveis, como atividade antimicrobiana e alta biocompatibilidade. Desta forma, o presente trabalho objetivou relatar um caso clínico de proteção pulpar direta com Agregado Trióxido Mineral em um molar decíduo com agenesia do sucessor permanente. Após o procedimento de proteção pulpar direta, as respostas teciduais foram acompanhadas clínica e radiograficamente durante dois anos e dois meses. Não foi observada a formação de tecido dentário, devido à avançada idade dentária. Entretanto, o Agregado Trióxido Mineral funcionou como uma barreira física capaz de vedar o tecido pulpar, mantendo-se a vitalidade pulpar, com ausência de sintomatologia dolorosa; demonstrou-se, assim, ser um material efciente para o tratamento conservador pulpar direto de dentes decíduos, mesmo com idade dental avançada e agenesia do elemento sucessor.

The preservation of primary teeth in arch has fundamental importance on establishing of normal occlusion, mainly in cases of teeth agenesis. Direct pulp protection is a conservator treatment which main objective is the maintenance of pulp vitality and teeth function in arch. Mineral Trioxide Aggregate is a material used due to favorable properties as antimicrobial activity and high biocompatibility. Therefore, the objective of the present work was to relate a case report of direct pulp protection with Mineral Trioxide Aggregate in a primary molar with successor permanent agenesis. After direct pulp protection procedures, tissue responses were clinically and radiographically assessed during two years and two months.It was not observed dental tissue formation, probably due to advanced dental age. Mineral Trioxide Aggregate act as physical barrier, isolating pulp tissue, maintaining teeth vitality and absence of pain, thus demonstrating effciency, even in teeth with advanced age mainly in cases of tooth agenesis.