Light-curing of calcium hydroxide-based liners: pH analysis and calcium ion release / Fotoativação de forradores a base de hidróxido de cálcio: análise de pH e liberação de íons cálcio

Objective: Compare the pH values and calcium ion release of calcium hydroxide-based liner materials before and after light-curing. Material and Methods: The materials evaluated were: hydrox-cal white (HW), hydrox-cal dentin (HD), Biocal (BC) and UltraBlend Plus (UB). 120 samples of the liner materials were inserted into a PVC tube (n=15). The samples from HW+A, HD+A, BC+A and UB+A were subjected to photoactivation. The other groups HW+N, HD+N, BC+N and UB+N were only inserted in a glass tube with deionized water. The pH was measured 24 hours and 14 days after the inclusion of the samples with the aid of a pH meter. The calcium release was analyzed with the aid of an atomic absorption spectophotometer at 24h and 14 days. The results were submitted to the Shapiro-Wilk test, followed by ANOVA and Tukey test (p=0.05). Results: In 24h, the groups that were not light cured showed the highest pH values (p<0.05). In 14 days, BC+N and BC+A demonstrated the lowest pH values. The groups that were not light cured also showed higher calcium release values in 24h and 14 days (p<0.05). Conclusion: Photoactivation of calcium hydroxide-based liner materials negatively interferes with calcium ion release, as well as with pH.(AU)

Objetivo: Comparar os valores de pH e liberação de íons cálcio de materiais forradores à base de hidróxido de cálcio antes e depois da fotopolimerização. Material e métodos: Os materiais avaliados foram: Hidrox-cal branco (HW), Hidrox-cal dentina (HD), Biocal (BC) e UltraBlend Plus (UB). 120 amostras dos materiais de revestimento foram inseridas em um tubo de PVC (n=15). As amostras de HW +A, HD+A, BC+A e UB+A foram submetidas à fotoativação. Os demais grupos HW +N, HD+N, BC+N e UB+N foram inseridos apenas em um tubo de vidro com água deionizada. O pH foi medido 24 horas e 14 dias após a inclusão das amostras com o auxílio de um medidor de pH. A liberação de cálcio foi analisada com o auxílio de um espectrofotômetro de absorção atômica em 24h e 14 dias. Os resultados foram submetidos ao teste de Shapiro-Wilk, seguido de ANOVA e teste de Tukey (p=0,05). Resultados: Em 24h, os grupos não fotopolimerizados apresentaram os maiores valores de pH (p<0,05). Em 14 dias, BC+N e BC+A apresentaram os menores valores de pH. Os grupos não fotopolimerizados também apresentaram maiores valores de liberação de cálcio em 24h e 14 dias (p<0,05). Conclusão: A fotoativação de materiais de revestimento à base de hidróxido de cálcio interfere negativamente na liberação de íons cálcio e no pH (AU)

Pulpectomies with Iodoform Versus Calcium Hydroxide-Based Paste: A Preliminary Randomised Controlled Clinical Trial

ABSTRACT Objective: To compare clinical and radiographical pulpectomy outcomes in primary teeth filled with different pastes. Material and Methods: The sample included thirty-eight teeth indicated for pulpectomy due to irreversible pulp inflammation or necrosis from thirty patients (2 to 9 years old). The first appointment comprised chemomechanical preparation (2.5% sodium hypochlorite), smear layer removal (6% citric acid), intracanal dressing and temporary restoration. Seven days later, teeth were randomly assigned to filling with iodoform (IP) or calcium hydroxide with zinc oxide (CHZO) based pastes and temporarily restored. Final restoration (composite resin) occurred at the 3rd appointment. Data from baseline, 6 and 12 months were analysed using descriptive and inferential statistics (p≤0.05). Results: The overall frequency of success was 63.6% (n=21), with no significant difference between groups (IP=62.5% n=10; CHZO=64.7% n=11, p=0.59). Multiradicular teeth, overfilled canals and teeth whose coronal restoration have been lost were significantly associated with failure (p=0.01, p=0.04 and p<0.001, respectively). Conclusion: After 12 months, both pastes showed similar outcomes and can be used as good options for pulpectomies in primary teeth. Moreover, tooth location, extent of the root canal filling, and integrity of final restoration during the follow-up influenced the outcome of pulpectomies.

Investigation of the effect of indirect pulp capping materials on dentin mineral density

Aim: To evaluate the potential of inducing mineral density changes of indirect pulp capping materials applied to demineralized dentin. Methods: A total of 50 cavities were prepared, 5 in each tooth, in extracted ten molars without caries, impacted or semi-embedded. The cavities were scanned by microcomputed tomography (µ-CT) after creating artificial caries by microcosm method (pre-treatment). Each cavity was subjected to one of 5 different experimental conditions: control (dental wax), conventional glass ionomer cement (Fuji IX GP Extra), resin-modified calcium silicate (TheraCal LC), resin-modified calcium hydroxide (Ultra-Blend Plus), MTA (MM-MTA) and the samples were kept under intrapulpal pressure using simulated body fluid for 45 days. Then, the second µ-CT scan was performed (post-treatment), and the change in dentin mineral density was calculated. Afterward, elemental mapping was performed on the dentinal surfaces adjacent to the pulp capping agents of 5 randomly selected samples using energy dispersive X-ray spectroscopy (EDS) apparatus attached to a scanning electron microscope (SEM). The Ca/P ratio by weight was calculated. Friedman test and Wilcoxon Signed Ranks test were used to analyze the data. Results: There was a significant increase in mineral density values of demineralized dentin after treatment for all material groups (p<0.05). Resin-modified calcium silicate had similar efficacy to MTA and conventional glass ionomer cement, but was superior to resin-modified calcium hydroxide in increasing the mineral density values of demineralized dentin. Conclusions: Demineralized dentin tissue that is still repairable can be effectively preserved using materials with remineralization capability

Antibacterial effect of low-temperature plasma on Enterococcus faecalis in dentinal tubules in vitro / 北京大学学报(医学版)

OBJECTIVE@#To construct a model of Enterococcus faecalis (E. faecalis) infection in dentinal tubules by gradient centrifugation and to evaluate the antibacterial effect of low-temperature plasma on E. faecalis in dentinal tubules.@*METHODS@#Standard dentin blocks of 4 mm×4 mm×2 mm size were prepared from single root canal isolated teeth without caries, placed in the E. faecalis bacterial solution, centrifuged in gradient and incubated for 24 h to establish the model of dentinal tubule infection with E. faecalis. The twenty dentin blocks of were divided into five groups, low-temperature plasma jet treatment for 0, 5 and 10 min, calcium hydroxide paste sealing for 7 d and 2% chlorhexidine gel sealing for 7 d. Scanning electron microscopy and confocal laser scanning microscope were used to assess the infection in the dentinal tubules and the antibacterial effect of low-temperature plasma.@*RESULTS@#The results of scanning electron microscopy and confocal laser scanning microscopy showed that after 24 h of incubation by gradient centrifugation, E. faecalis could fully enter the dentinal tubules to a depth of more than 600μm indicating that this method was time-saving and efficient and could successfully construct a model of E. faecalis infection in dentinal tubules. Low-temperature plasma could enter the dentinal tubules and play a role, the structure of E. faecalis was still intact after 5 min of low-temperature plasma treatment, with no obvious damage, and after 10 min of low-temperature plasma treatment, the surface morphology of E. faecalis was crumpled and deformed, the cell wall was seriously collapsed, and the normal physiological morphology was damaged indicating that the majority of E. faecalis was killed in the dentinal tubules. The antibacterial effect of low-temperature plasma treatment for 10 min exceeded that of the calcium hydroxide paste sealing for 7 d and the 2% chlorhexidine gel sealing for 7 d. These two chemicals had difficulty entering deep into the dentinal tubules, and therefore only had a few of antibacterial effect on the bacterial biofilm on the root canal wall, and there was also no significant damage to the E. faecalis bacterial structure.@*CONCLUSION@#Gradient centrifugation could establish the model of E. faecalis dentin infection successfully. Low-temperature plasma treatment for 10 min could kill E. faecalis in dentinal tubules effectively, which is superior to the calcium hydroxide paste sealing for 7 d and the 2% chlorhexidine gel sealing for 7 d.

Calcium hydroxide diffusion after agitation of endodontic irrigants: an ex vivo study

Aim: To compare the influence of two methods of agitation of endodontics irrigants, by diffusion of calcium hydroxide [Ca(OH)2] through the dentinal tubules, measuring the pH of the medium where they were kept. Methods: Twenty mandibular incisors were prepared using a WaveOne Gold Large file, in a reciprocating movement, and then divided into (n = 10): gutta-percha cone (GPC) or Easy Clean system (ECS) agitation of 1% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The specimens were filled with Ca(OH)2 paste, placed in flasks with 4 mL of deionized water, and stored in an incubator. The pH was read using a digital pH meter immediately after storage (T0), after 7 (T1), 14 (T2), 21 (T3), and 35 (T4) days. Results: Statistical difference between groups was observed regardless of the day pH was measured (p < 0.01). From T2 on, ECS presented higher pH values in comparison with GPC, with significant difference (p < 0.01). Conclusion: Agitation of endodontic irrigants with ECS enhances the Ca(OH)2 diffusion, providing higher pH values, from the 14th day on, when compared with GPC

Response of dental pulp capped with calcium-silicate based material, calcium hydroxide and adhesive resin in rabbit teeth

Direct pulp capping induces a local inflammatory process. Several biomaterials have been used for this procedure. The aim of this study was to compare the dentinal bridge thickness using three different pulp capping biomaterials with the conventional technique (high speed diamond bur) or Er-Yag laser, 1 month after pulp effraction. Materials and Methods: Forty two Class V cavities were prepared on the buccal surface of 4 maxillary incisors and 2 mandibular incisors of New Zealand rabbits. Specimens were divided into 6 treatment groups. Teeth were treated with: In Group 1: Er-Yag laser and Biodentine® (Septodont), in Group 2: Er: Yag laser and calcium hydroxide (Dycal® Dentsply), in Group 3: Er: Yag laser and adhesive system (Prime& Bond® NT Dentsply), in Group 4: high speed diamond bur and Biodentine® (Septodont), in Group 5: high speed diamond bur and calcium hydroxide (Dycal® Dentsply), and in Group 6: high speed diamond bur and adhesive system (Prime& Bond® NT Dentsply). The preparation was done with copious irrigation. The animals were sacrificed at 30 days and the teeth were extracted and prepared for histological analysis. Results: In the group of « laser Er-Yag ¼, iatrogenic pulpal wounds treated with Biodentine® were covered with a thick hard tissue barrier after 1 month. The difference was not significant with the groups of Dycal® used with Er: Yag laser and high speed diamond bur. Prime& Bond® NT Dentsply specimens showed a thin dentinal bridge layer. Conclusion: At 1 month, Er-Yag laser proved to be useful with Biodentine® for direct pulp capping procedures

Effect of liners on composite resin microleakage after selective carious lesion removal: an experimental study / Efecto de los recubrimiento en la microfiltración de resina compuesta después de la eliminación selectiva de lesiones cariosas: un estudio experimental

Objetive: To evaluate microleakage of composite resins (CR) placed over different cavitary liners after managing deep caries lesions through selective removal of soft carious tissue to soft dentin (SRCT-S). Material and Methods: Fifty four human teeth were collected for microleakage testing. Each assay comprised ICDAS 5 or ICDAS 6 carious lesions and sound teeth for controls. Sound teeth were prepared with cavities that mirrored the carious teeth cavities, which were prepared with SRCT-S. Sound and carious teeth were further randomly assigned to one of the three experimental groups: Group A: universal adhesive (UA) + CR, Group B: glass ionomer cement liner + UA + CR, and Group C: calcium hydroxide + UA+ CR. Occlusal microleakage (OM) and cervical microleakage (CM) was classified within one of 5 depth categories. ANOVA and Chi-square tests were computed (p<0.05). Results: OM and CM were similarly distributed across subgroups (p>0.05). All Group C samples with carious lesions presented some degree of microleakage. However, no statistically significant differences were observed between groups and within each group (p>0.05). Conclusion: Teeth restored with CR after SRCT-S using calcium hydroxide as a liner material seem to exhibit higher microleakage than those restored using glass ionomer or UA alone. Further clinical research is needed to deepen these findings. Clinical significance: The application of calcium hydroxide as a liner under a composite resin may reduce the longevity of a restoration after performing selective or partial removal of carious tissues. Clinicians should rethink the need of using calcium hydroxide for this application, albeit the lack of clinical evidence.

Objetivo: Evaluar la microfiltración de resinas compuestas (RC) colocadas sobre diferentes liners cavitarios después del manejo de lesiones de caries profundas mediante la remoción selectiva de tejido cariado blando hasta dentina blanda (SRCT-S). Material y Métodos: Se recolectaron 54 dientes humanos para pruebas de microfiltración. Cada ensayo comprendía lesiones cariosas ICDAS 5 o ICDAS 6 y dientes sanos para los controles. Se prepararon dientes sanos con cavidades que reflejaban las cavidades de los dientes cariados, que se prepararon con SRCT-S. Los dientes sanos y cariados se asignaron al azar a uno de los tres grupos experimentales: Grupo A: adhesivo universal (AU) + RC, Grupo B: revestimiento de cemento de ionómero de vidrio + AU + RC, y Grupo C: hidróxido de calcio + AU+ RC. La microfiltración oclusal (MO) y la microfiltración cervical (MC) se clasificaron dentro de una de las 5 categorías de profundidad. Se calcularon las pruebas ANOVA y Chi-cuadrado (p<0,05). Resultados: La MO y MC se distribuyeron de manera similar en los subgrupos (p> 0,05). Todas las muestras del Grupo C con lesiones cariosas presentaron algún grado de microfiltración. Sin embargo, no se observaron diferencias estadísticamente significativas entre grupos y dentro de cada grupo (p>0,05). Conclusión: Los dientes restaurados con RC después de SRCT-S usando hidróxido de calcio como material de revestimiento parecen exhibir una mayor microfiltración que aquellos restaurados usando ionómero de vidrio o AU solo. Se necesita más investigación clínica para profundizar estos hallazgos. Relevancia clínica: la aplicación de hidróxido de calcio como revestimiento debajo de una resina compuesta puede reducir la longevidad de una restauración después de realizar la eliminación selectiva o parcial de los tejidos cariados. Los médicos deberían reconsiderar la necesidad de usar hidróxido de calcio para esta aplicación, aunque no haya evidencia clínica.

An unusual repair of perforating internal inflammatory root resorption; a case report of endodontic treatment

Internal inflammatory root resorption (IIRR) can occur as a serious complication of dental trauma which leads to progressive loss of the root structure. An early diagnosis could influence the therapeutic approach, but endodontic treatment becomes a challenge with a doubtful prognosis. The present report described an unusual clinical presentation of an IIRR with perforation resulting from a trauma four years previous. A 15-year-old female patient was presented to our service with pain in the maxillary incisor region. Intraoral radiography revealed a large radioloucent area compatible with IIRR, communicating with the periodontium in the middle third on the distal root face of the right central incisor. The root canal of the right central incisor was chemo-mechanically prepared. The calcium hydroxide (CH) intracanal medication was used and renewed periodically four times. The root canal was filled only in the cervical region to the level of resorption by the inverted gutta-percha cone technique. Clinically and radiographically, all follow-up examinations revealed an asymptomatic tooth, evidencing periapical tissue repair and new bone formation. The tooth remained asymptomatic 3 years afterwards. The present case report supports the idea of executing satisfactory intracanal decontamination by chemo-mechanical preparation, thus creating a favourable environment for tissue repair.

Láser de baja intensidad en pulpotomía de dientes primarios / Laser de baixa intensidade em pulpotomia de dentes decíduos / Low-level laser in pulpotomy of deciduous teeth

Las altas tasas de lesiones cariosas en niños y adolescentes pueden resultar en la exposición pulpar o incluso en la pérdida temprana del diente primario, situación que requiere una acción mínimamente invasiva por parte del odontólogo, para preservar el diente en la cavidad bucal. La pulpotomía, un tipo de terapia pulpar vital destinada a tratar de forma reversible las lesiones relacionadas con la cámara pulpar, utiliza diferentes técnicas para mantener el diente vital en la cavidad oral hasta la exfoliación. Objetivo: demostrar la efectividad de la técnica de Terapia Láser de Baja Intensidad (LBI) en comparación con el Hidróxido de Calcio en el procedimiento de pulpotomía de dientes primarios. Materiales y Métodos: La investigación fue un ensayo clínico longitudinal con nueve molares primarios de niños de 5 a 12 años. Las evaluaciones clínicas y radiográficas se realizaron después de períodos de 1, 2, 3 y 6 meses. Resultados: Hubo un índice de éxito clínico en cuanto a ausencia de dolor, sensibilidad a la percusión, inflamación y, radiográficamente, ausencia de resorción interna o externa o lesiones de furca en el 100% de los casos. Conclusión: El LBI demuestra beneficios como la ausencia de dolor, el efecto antiinflamatorio y la ausencia de efectos adversos. Por tanto, se sugiere que la LBI puede considerarse una técnica alternativa para la pulpotomía en la práctica clínica. Sin embargo, se recomiendan más estudios clínicos sobre el tema

: Os índices elevados de lesões cariosas em crianças e adolescentes podem resultar em exposição da polpa ou até mesmo na perda precoce do dente decíduo, situação que exige atuação minimamente invasiva do cirurgião-dentista, visando preservar o dente na cavidade bucal. A pulpotomia, um tipo de terapia pulpar vital que visa tratar de forma reversível as injúrias relacionadas à câmara pulpar, utiliza diferentes técnicas com a finalidade de manter o dente vital na cavidade bucal até a sua esfoliação. Objetivo: evidenciar a eficácia da técnica de Laser terapia de Baixa Intensidade (LBI) comparada com o Hidróxido de Cálcio no procedimento de pulpotomia de dentes decíduos. Materiais e método: A pesquisa foi um ensaio clínico longitudinal com nove molares decíduos de crianças com idade entre 5 e 12 anos. Foram realizadas avaliações clínicas e radiográficas após os períodos de 1, 2, 3 e 6 meses. Resultados: Observou-se índice de sucesso clínico quanto à ausência de dor, de sensibilidade à percussão, de inchaço anormal e, radiograficamente, de ausência de reabsorção interna ou de externa ou lesão de furca em 100% dos casos. Conclusão: O LBI demonstra benefícios como a ausência de dor, o efeito anti-inflamatório e a ausência de efeitos adversos. Desta forma, sugere-se que o LBI possa ser considerado uma técnica alternativa para pulpotomia na prática clínica. Porém recomenda-se mais estudos clínicos sobre o assunt

The high rates of carious lesions in children and adolescents can result in pulp exposure or even early loss of the primary tooth, a situation that requires minimally invasive action by the dentist, in order to preserve the tooth in the oral cavity. Pulpotomy, a type of vital pulp therapy aimed at reversibly treating injuries related to the pulp chamber, uses different techniques in order to keep the vital tooth in the oral cavity until exfoliation. Aim: to demonstrate the effectiveness of the Low Intensity Laser Therapy (LBI) technique compared to Calcium Hydroxide in the pulpotomy procedure of primary teeth. Materials and methods: The research was a longitudinal clinical trial with nine primary molars of children aged 5 to 12 years. Clinical and radiographic evaluations were performed after periods of 1, 2, 3 and 6 months. Results: There was an index of clinical success regarding the absence of pain, sensitivity to percussion, abnormal swelling and, radiographically, the absence of internal or external resorption or furcation lesions in 100% of the cases. Conclusion: The LBI demonstrates benefits such as the absence of pain, the anti-inflammatory effect and the absence of adverse effects. Thus, it is suggested that LBI can be considered an alternative technique for pulpotomy in clinical practice. However, further clinical studies on the subject are recommended

Comparative evaluation of inter appointment pain and analgesic intake with calcium hydroxide and triple antibiotic paste as intracanal medicaments in patients with apical periodontitis ­ a randomized controlled single-blinded clinical trial / Avaliação comparativa da dor entre consultas e ingestão de analgésicos com hidróxido de cálcio e pasta de antibióticos triplos como medicamentos intracanais em pacientes com periodontite apical - um ensaio clínico randomizado controlado simples-cego

Objective: This study aimed to evaluate the effect of calcium hydroxide and triple antibiotic paste as intracanal medication on the interappointment pain at 8, 24, and 48 hours postoperatively in patients with symptomatic apical periodontitis undergoing multiple visit root canal treatment. Material and Methods: Two hundred and seven systemically healthy patients under the age group of 18-45 years with mandibular molars presenting with symptomatic apical periodontitis which require root canal treatments were included in this study. After access cavity preparation, cleaning and shaping was done till ISO 25 size file, and the patients were randomized into three groups (each group of 69 samples). Group I: no medicament, group II: calcium hydroxide and group III: triple antibiotic paste (TAP). Postoperative pain was evaluated at 8 hours, 24 hours and 48 hours. Results: The results showed that at 8 hours, 24hours and 48hours, there was a statistical difference between I and III (p < 0.05); and Group III and Group II (p < 0.05). Within the group, there was a statistical difference at all time points IN Group I and II (p < 0.05) except between 24 hours and 48 hours in the Group III (p > 0.05). Conclusion: Within the limitations of this study, TAP was more effective than calcium hydroxide in relieving pain and reducing the analgesic intake at the first 24hours.(AU)

Objetivo: Este estudo teve como objetivo avaliar o efeito do hidróxido de cálcio e da pasta tripla de antibiótico como medicação intracanal na dor na interconsulta às 8, 24 e 48 horas de pós-operatório em pacientes com periodontite apical sintomática submetidos ao tratamento endodôntico por múltiplas visitas. Material e Métodos: Duzentos e sete pacientes sistemicamente saudáveis com idade inferior a 18-45 anos com molares inferiores apresentando periodontite apical sintomática que requerem tratamento de canal radicular foram incluídos neste estudo. Após o preparo da cavidade de acesso, a limpeza e modelagem foram feitas até arquivo ISO 25, e os pacientes foram randomizados em três grupos (cada grupo de 69 amostras). Grupo I: sem medicamento, grupo II: hidróxido de cálcio e grupo III: pasta tripla de antibiótico (TAP). A dor pós-operatória foi avaliada em 8 horas, 24 horas e 48 horas. Resultados: Os resultados mostraram que às 8 horas, 24 horas e 48 horas, houve diferença estatística entre I e III (p <0,05); e Grupo III e Grupo II (p <0,05). Dentro do grupo, houve diferença estatística em todos os momentos do Grupo I e II (p <0,05), exceto entre 24 horas e 48 horas no Grupo III (p>0,05). Conclusão: Dentro das limitações deste estudo, o TAP foi mais eficaz do que o hidróxido de cálcio no alívio da dor e na redução da ingestão de analgésicos nas primeiras 24 horas. (AU)

Physicochemical properties and antimicrobial activity of calcium hydroxide pastes in association with other compounds

Aim: This study aimed to evaluate the pH, Ca2+ release, solubility, and antimicrobial activity of calcium hydroxide (Ca(OH)2) pastes in association with different substances. Methods: Sixty acrylic teeth (n=10) were filled with pastes that associated Ca(OH)2 with the following substances: benzalkonium chloride 5% (G1) and 50% (G2) both in propylene glycol, arnica glycolic extract (G3), green tea glycolic extract (G4), Calen/PMCC™ (G5), and Calen™ (G6). In the group G1 to G4 were used 1g of Ca(OH)2 powder with 0,8g of vehicle. pH and Ca2+ release was measured after 7, 15, and 30 days. For solubility, micro-CT was used immediately and at the periods of 7, 15, and 30 days. For the antimicrobial analysis, a biofilm of E. faecalis was induced in vitro on bovine dentin discs. Live/dead viability dye and confocal scanning microscopy were used. Results: The highest pH values occurred on the first 7 days, and the G6, G1, G3, and G5 presented the highest pH values at this period (P <0.05). Ca2+ release was higher in all groups at 7 days, with the highest values observed in G1, G5, and G6. The volume of all pastes showed no significant difference in the intragroup analysis at 7 and 15 days (P <0.05). G1 and G2 showed the highest antimicrobial action (P <0.05). For the biovolume, there was difference between the G6 and the other groups (P >0.05) with G1 presenting the lowest values. Conclusion: Benzalkonium chloride 5% increases the antimicrobial action of the Ca(OH2), without impairs physicochemical properties

Comparação de diferentes técnicas e pastas obturadoras em pulpectomias de dentes decíduos bovinos: estudo in vitro / Comparison of different techniques and obtaining paste in bovine decidual teeth pulpectomies: in vitro study

A manutenção dos dentes decíduos na cavidade bucal até o período de sua esfoliação fisiológica é de extrema importância. A terapia endodôntica é um tratamento indicado quando a saúde do tecido pulpar é comprometida e diversas técnicas e materiais podem ser empregados para realizar a obturação de canais radiculares. O objetivo deste estudo in vitro foi comparar a qualidade do preenchimento dos canais radiculares utilizando diferentes técnicas de obturação e pastas obturadoras em dentes decíduos bovinos submetidos à pulpectomia. Foram selecionados 30 incisivos decíduos bovinos, e preparados através da técnica manual com posterior obturação dos canais radiculares por meio de duas técnicas e três pastas obturadoras. Os dentes foram divididos em 6 grupos (n= 5/ grupo) da seguinte forma: GI ­ Técnica manual e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GII ­ Técnica manual e pasta Guedes-Pinto Modificada; GIII ­ Técnica manual e pasta Feapex®; GIV ­ Técnica com auxílio da lentulo e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GV ­ Técnica com auxílio da lentulo e pasta Guedes-Pinto Modificada; GVI ­ Técnica com auxílio da lentulo e pasta Feapex®. Foram realizadas as radiografias digitais para verificar a qualidade do preenchimento dos canais radiculares. Os resultados obtidos apresentaram diferenças significativas na qualidade do preenchimento dos canais radiculares entre os grupos de dentes decíduos bovinos obturados. Considerando os resultados obtidos e a metodologia empregada, pode-se concluir que existe diferença entre as técnicas de obturação e pastas obturadoras(AU)

Maintaining primary teeth in the oral cavity until the period of their physiological exfoliation is extremely important. An endodontic therapy is a treatment indicated when the health of the pulp tissue is compromised and several techniques and materials can be used to perform root canal filling. The aim of this in vitro study was to compare the quality of root canal filling using different filling techniques and filling masses in primary bovine teeth implanted under pulpectomy. Thirty bovine primary incisors were selected and prepared using the manual technique with subsequente filling of the root canals using two techniques and three filling materials. The teeth were divided into 6 groups (n= 5 / group) as follows: GI - Technical Manual and Calcium Hydroxide Mass PA thickened with Zinc Oxide; GII - Manual technique and modified Guedes-Pinto pasta; GIII - Manual technique and Feapex® paste; GIV - Technique with the aid of lentulo and mass of Calcium Hydroxide PA thickened with Zinc Oxide; GV ­ Technique with the aid of lentulo and modified Guedes-Pinto mass; GVI - Technique with the aid of lentulo and Feapex® mass. Digital radiographs were taken to check the quality of the filling of the root canals. The resulting results dissipated in the quality of filling the root canals between the groups of primary bovine teeth filled. Know the results obtained and the methodology used, it can be concluded that there is a difference between filling techniques and filling masses(AU)

Avaliação de tampão apical em dentes bovinos permanentes jovens com hidróxido de cálcio e MTA: um estudo in vitro / Evaluation of apical plug in young permanent bovine teeth with calcium hydroxide and MTA: an in vitro study

O objetivo do presente estudo in vitro foi avaliar, por meio de radiografia digital, a qualidade de preenchimento dos canais de dentes incisivos bovinos permanentes jovens quando realizado tampão apical com hidróxido de cálcio e MTA associados a outros materiais e posteriormente obturados. Foram utilizados dentes incisivos permanentes bovinos com rizogênese incompleta preparados de forma manual com as limas tipo K, irrigados com hipoclorito de sódio 1% e soro fisiológico. Após, foram utilizados os materiais indicados para confecção do tampão apical: hidróxido de cálcio P.A associado ao propilenoglicol e ao iodofórmio; hidróxido de cálcio P.A juntamente com MTA e propilenoglicol e somente MTA, em seguida obturados com cones de guta percha e cimento AH Plus e radiografados para avaliação. Os dados foram submetidos ao teste Qui-Quadrado de Pearson e Teste exato de Fisher com nível de significância de 5%. Os resultados obtidos não apresentaram diferença estatisticamente significativa entre os três grupos, sendo que o valor resultado foi de p=0,442, porém o grupo composto pelo cimento de hidróxido de cálcio P.A associado ao MTA e propilenoglicol apresentou uma qualidade de preenchimento boa (100 %) em relação aos outros cimentos avaliados, que se mostraram satisfatório (40%) e bom (60%) no procedimento de apicificação. Não houve diferença significativa de qualidade de preenchimento de tampão apical nos grupos, no entanto o grupo composto pelo hidróxido de cálcio P.A. associado ao MTA e propilenoglicol apresentou resultado superior(AU)

The objective of the present in vitro study was to evaluate, through digital radiography, the quality of filling in the young permanent bovine incisor teeth canals when the apical buffer was performed with calcium hydroxide and MTA associated with other materials and subsequently filled. Permanent bovine incisor teeth with incomplete rhizogenesis were prepared manually with K files type, irrigated with 1% sodium hypochlorite and saline. Afterwards, the materials indicated for making the apical buffer were used: calcium hydroxide P.A associated with propylene glycol and iodoform; calcium hydroxide P.A together with MTA and propylene glycol and only MTA, then filled with gutta-percha cones and AH Plus cement and radiographed for evaluation. The data were submitted to the Pearson's Chi-square test and Fisher's exact test with a significance level of 5%, once the result value was p=0,442. The results obtained showed no statistically significant difference between the three groups, the result being p=0,442, however the group composed of calcium hydroxideP.A. cement associated with MTA and propylene glycol showed a good filling quality (100%) in relation to the other evaluated cements, which were satisfactory (40%) and good (60%) in apexification procedure. There was no significant difference in quality of plug apical filling in the groups, however the group composed of calcium hydroxide P.A cement associated with MTA and propylene glycol showed a superior result(AU)

Procedimentos regenerativos endodônticos com clorexidina a 2% e hidróxido de cálcio: relato de caso / Endodontic regenerative procedures with 2% chlorhexidine and calcium hydroxide: case report

Introdução: Muitas substâncias têm sido utilizadas como irrigantes e curativos intracanal nos tratamentos de dentes com rizogênese incompleta, visando obter a regeneração pulpar. A clorexidina a 2% em associação com hidróxido de cálcio P.A. pode ser uma alternativa. Métodos: No presente caso clínico, o dente #45 com periodontite apical, em um paciente com 13 anos de idade, foi tratado com solução de clorexidina a 2% como irrigante. A clorexidina na forma de gel a 2% foi utilizada como auxiliar da instrumentação e, em associação com o hidróxido de cálcio, foi utilizada como curativo durante 14 dias. Após esse período, o canal foi irrigado com solução fisiológica e, sob anestesia alveolar mandibular, uma lima K #70 foi utilizada ultrapassando levemente o ápice, para causar sangramento. Após observar que o sangue dentro dos canais alcançou a porção cervical, o cimento biocerâmico MTA Branco foi colocado na porção cervical do canal. Resultados: A apicificação e o desenvolvimento da raiz em comprimento e largura puderam ser observados já no controle de três meses, e continuaram até a última revisão, no controle de um ano. Alterações de cor não foram observadas nese período de acompanhamento. Conclusões: A clorexidina associada ao hidróxido de cálcio pode ser uma alternativa aos procedimentos de regeneração pulpar (AU).

Introduction: Many substances have been used as irrigating solutions to promote pulp regeneration and root development in teeth with incomplete rhizogenesis. The use of 2% chlorhexidine as an irrigating solution in association with Calcium Hydroxide could be an alternative. Methods: In the case of the patient, a 13-year-old boy, here presented, tooth 45 with apical periodontitis was treated with 2% Chlorhexidine solution as irrigant adjuvant to instrumentation, in association with Calcium Hydroxide used as a dressing for 14 days. After this period, the canal was cleaned with a physiological solution and under mandibular alveolar anesthesia, a # 70 K file was used slightly over the apex to cause bleeding. After observing that blood inside the canals had reached the cervical portion. White MTA was placed in the cervical portion of the canal. Results: Induced apexification and development of increasing root length and width could already be observed in the three-month control exam, and this continued until the last review in the one-year control exam. No color changes were observed in this follow-up period. Conclusions: Chlorhexidine and calcium hydroxide could be used as an alternative to pulp regeneration procedures (AU).

Reabsorção radicular interna de incisivos superiores permanentes tratados endodonticamente / Internal radicular reabsorption of endodontically treated permanent upper incisives

As reabsorções radiculares são classificadas em interna e externa e um correto diagnóstico é fundamental para o sucesso no tratamento e é de suma importância que a resolução clínica seja feita precocemente para que se tenha um prognóstico clínico favorável. Reabsorção interna não é comum em dentes permanentes, e seu processo se caracteriza por um aumento do canal radicular de forma oval. O presente estudo teve como objetivos demonstrar e descrever através de um relato de prontuário o tratamento de reabsorção radicular interna de incisivos superiores permanentes. Através da seleção de uma paciente pela disciplina de Triagem da clínica odontológica do Centro Universitário da Serra Gaúcha, a qual apresentou alterações radiográficas compatíveis com reabsorção radicular interna inflamatória na região de dois incisivos superiores permanentes, com lesão periapical estabelecida em ambos, concluiu-se o tratamento para então gerar este estudo do tipo retrospectivo observacional. A reabsorção quando não tratada pode avançar e envolver estruturas além do tecido conjuntivo inflamado e a lesão pode avançar em direção apical. Após estabelecido o diagnóstico, iniciou-se os tratamentos endodônticos dos elementos utilizando hidróxido de cálcio como medicação intracanal, após as trocas de medicações as reabsorções foram controladas e então, as obturações dos canais foram realizadas, buscando um preenchimento adequado para o caso. A reabsorção radicular interna inflamatória causa danos irreversíveis, mas seu processo foi controlado através de terapia endodôntica. Este desempenho é considerado uma patologia, e pode comprometer qualquer extensão da raiz, é comum que os casos permaneçam assintomáticos, portanto, deve ser tratado o mais breve possível assim que descobertos para evitar sua progressão, e consequentemente danos maiores(AU)

Root resorption is classified as either internal or external, and a correct diagnosis is essential for successful treatment. Internal resorption is not common in permanent teeth, and its process is characterized by an enlarged oval root canal. The present study aims to demonstrate and describe, through a medical record, the treatment of internal root resorption of permanent upper incisors. A patient was selected from the Triage Course of the Dental Clinic (Centro Universitário da Serra Gaúcha) who presented radiographic changes associated with inflammatory internal root resorption in two permanente upper incisors, with a periapical lesion established in both and a treatment was then carried out in order to generate this retrospective observational study. Resorption when left untreated can progress and involve structures beyond the inflamed connective tissue and the lesion can advance in the apical direction. After the diagnosis was confirmed, endodontic treatments were initiated using calcium hydroxide as an intracanal medication. After changing the medication, the resorption was controlled and then the canal fillings were performed, seeking an adequate filling for the case. Inflammatory internal root resorption causes irreversible damage, but its process has been controlled through endodontic therapy. This performance is considered a pathology, and can compromise any extension of the root, it is common for the cases to remain asymptomatic, therefore, it should be treated as soon as it's discovered to prevent its progression, and consequently greater damage(AU)

Formulação, análise físico-química e microbiológica de cimentos endodônticos bioativos / Formulation, physicochemical and microbiological analysis of bioactive endodontic cements

Os cimentos endodônticos bioativos apresentam inúmeras aplicações clínicas, devido as suas propriedades biológicas, como a bioatividade; alta capacidade de vedação; ação antimicrobiana; liberação de íons cálcio, além de apresentar resposta inflamatória reduzida ou ausente. Baseada nesses benefícios, a presente pesquisa objetivou desenvolver e caracterizar cimentos endodônticos bioativos de baixo custo e efetividade antimicrobiana para uso na endodontia. Para isso, foram preparadas algumas formulações contendo cimentos finos, escória moída e celulose. Esses cimentos testes foram comparados com o MTA branco reparador da Angelus®. Sendo então divididos em quatro grupos: Grupo 1 (cimento fino cinza com escória moída cinza - MZVI e celulose); Grupo 2 (cimento branco cinza, escória moída branca - MPW e celulose); Grupo 3 (cimento fino branco e celulose) e Grupo 4 (MTA branco, Angelus ­ controle positivo). As amostras de cada grupo foram submetidas às análises de Difração de Raio-X (DRX), Análise Termogravimétrica (TG), Termogravimetria Derivada (DTG), Microscopia Eletrônica de Varredura (MEV), Potencial hidrogeniônico (pH), Picnometria, Espectroscopia de Infravermelho com Transformada de Fourier (FTIR) e Potencial Antibacteriano contra Enterococcus faecalis por meio do teste de difusão em ágar. Os testes estatísticos foram realizados utilizando o SPSS. As diferenças entre os grupos foram verificadas por meio do teste ANOVA com post hoc de Tukey, estatística descritiva e análises gráficas. Após a avaliação dos dados podese observar, principalmente, a presença de hidróxido de cálcio, silicato dicálcico, silicato tricálcico, aluminato tricálcico e carbonato de cálcio. Além disso, os cimentos apresentaram pH alcalino, ação antimicrobiana contra Enterococcus faecalis e na análise do MEV foi possível observar partículas de dimensões irregulares com uma distribuição heterogênea na matriz polimérica, contrastando com a homogeneidade apresentada pelo MTA. Porém, nas demais características, os cimentos apresentaram, de forma geral, grande semelhança com o MTA branco da Angelus, com maior destaque para o grupo 2. Assim, pode-se concluir que é possível formular cimentos bioativos, reutilizando escórias e mantendo as propriedades físico-químicas e antimicrobiana presentes no MTA (AU).

Bioactive endodontic cements have numerous clinical applications due to their biological properties, such as bioactivity; high sealing capacity; antimicrobial action; realease of calcium ions, also having a reduced or no inflammatory response. Based on these benefits, the present research aimed to develop and characterize low cost bioactive endodontic cements and antimicrobial effectiveness for endodontic use. For this, some formulations containing fine cements, ground slag and cellulose were prepared. These test cements were compared with Angelus® repairing white MTA. It was then divided into four groups: Group 1 (gray fine cement with gray ground slag - MZVI and cellulose); Group 2 (white gray cement, white ground slag - MPW and cellulose); Group 3 (white fine cement and cellulose) and Group 4 (white MTA, Angelus ­ positive control). The samples from each group were subjected to X-Ray Diffraction (XRD), Thermogravimetric Analysis (TGA), Derived Thermogravimetry (DTG), Scanning Electron Microscopy (SEM), Hydrogen Potential (pH), Picnometry, Infrared Spectroscopy with Fourier Transform (FTIR) and Antibacterial Potential against Enterococcus faecalis through the agar diffusion test. Statistical tests were performed using SPSS. Differences between groups were verified using the ANOVA test with Tukey's post hoc, descriptive statistics and graphical analyses. After evaluating the data, it was possible to observe, mainly, the presence of calcium hydroxide, dicalcium silicate, tricalcium silicate, tricalcium aluminate and calcium carbonate. In addition, the cements showed alkaline pH, antimicrobial action against Enterococcus faecalis and in the SEM analysis it was possible to observe particles of irregular dimensions with a heterogeneous distribution in the polymer matrix, contrasting with the homogeneity presented by MTA. However, in the other characteristics, the cements showed, in general, great similarity with the white MTA from Angelus, with greater emphasis on group 2. Thus, it can be concluded that it is possible to formulate bioactive cements, reusing slag and maintaining the MTA physicochemical and antimicrobial properties (AU).

Retratamento endodôntico e complementação cirúrgica em dente com fístula persistente: relato de caso / Endodontic retreatment and surgical complementation on a tooth with persistent fistula: case report

Introdução: O preparo químico-mecânico representa uma etapa fundamental, pois promove a antissepsia do complexo sistema de canais radiculares, viabilizando um ambiente biológico favorável para o processo de cura e reparo dos tecidos periapicais. Porém, insucessos podem acontecer em dentes tratados e retratados endodonticamente, sendo a intervenção cirúrgica frequentemente indicada nesses casos. Relato do caso: Paciente do sexo masculino, 32 anos de idade, melanoderma, apresentou-se à clínica-escola de uma faculdade de Odontologia em um município baiano, com queixa principal de "aparecimento de bolha na gengiva e gosto amargo na boca". Ao exame clínico, visualizou-se presença de restauração de resina composta nas faces mesial e palatina, bem como fístula intrabucal ativa na região de fundo de vestíbulo, próximo ao ápice do elemento #22. Por meio de exames clínico e radiográfico, testes de sensibilidade pulpar e rastreamento da fístula, foi estabelecido diagnóstico de tratamento endodôntico concluído, e periapical de abscesso apical crônico. Em seguida, houve indicação de retratamento endodôntico e duas sessões de medicação intracanal com hidróxido de cálcio, seguidas de uma intervenção cirúrgica exploratória. Resultados: O protocolo de tratamento proposto foi eficaz. Constatou-se sucesso clínico, com cicatrização da fístula intrabucal ativa, e radiográfico, com reparação dos tecidos periapicais, além do restabelecimento da estética e função dentária, com acompanhamento de 26 meses. O paciente encontra-se sob acompanhamento semestral. Conclusão: é necessário salientar a relevância de efetuar com segurança um planejamento e prognóstico endodôntico confiável e, igualmente, o acompanhamento do caso, com supervisão clínica e radiográfica periódica (AU).

Introduction: Biological chemical preparation repre- sents a fundamental step, as it promotes asepsis of the complex root canal system, enabling a biological environment favorable to the process of healing and repair of the periapical tissues. However, failures can occur in endodontic treatment and retreatment teeth, where surgical intervention is often indicated in these cases. Description: The patient, a 32-year old man, melanoderma, presented at the school clinic of a School of Dentistry in a city in Bahia, with a chief complaint of "blistering of the gums and bitter taste in the mouth." Clinical examination revealed the presence of composite resin restoration on the mesial and palatine surfaces, and an active intraoral fistula in the vestibular region near the apex of tooth 22. By means of clinical, radiographic, pulp sensitivity tests and sinus tracking, a diagnosis of completed endodontic treatment was established, and periapical diagnosis of a chronic apical abscess. Afterwards, endodontic retreatment was indicated, consisting of two sessions of intracanal medication with calcium hydroxide, followed by an exploratory surgical intervention. Results: The proposed treatment protocol was effective. Clinical and radiographic success with healing of the active intrabuccal fistula and repair of the periapical tissues, as well as reestablishment of esthetics and dental function, was verified, in a period of twenty six months follow-up. At present, the patient is being followed-up semi-annually. Conclusion: it is necessary to emphasize the importance of safely performing reliable endodontic planning and prognosis, as well as follow up of the case, with periodic clinical and radiographic control (AU).

Estudo ex vivo da elevação do pH em superfície radicular externa após agitação ultrassônica de diferentes pastas de hidróxido de cálcio / Assessment of pH increase in the external root surface after ultrasonic agitation of different calcium hydroxide pastes: Ex vivo study

Objetivo: O presente estudo teve por objetivo avaliar, ex vivo, a capacidade de elevação do pH da superfície radicular externa de diferentes pastas de hidróxido de cálcio (HC) utilizadas como medicação intracanal, além da influência da ativação ultrassônica (AUS) durante aplicação no interior do canal radicular. Métodos: Foram utilizados 100 incisivos humanos superiores unirradiculares, que tiveram os canais radiculares modelados e divididos aleatoriamente em seis grupos experimentais (n=15), de acordo com a pasta de HC, tendo como variáveis as medicações utilizadas e a ativação da pasta com AUS no momento da aplicação, além de um grupo controle (n=10): Pasta Calen; HC+clorexidina 2% gel (CX2%); e HC + água destilada. Os dentes foram mantidos imersos em água deionizada e as medidas do pH, verificadas nos períodos de 7, 14, 21 e 28 dias, com auxílio de pHmetro. Resultados: De acordo com os dados obtidos, verificou-se elevação do pH nos períodos de 7 e 14 dias em todos os grupos. Apenas os grupos em que foi utilizada a associação do HC com CX2% apresentou evolução com aumento significativo do pH ao longo dos períodos analisados (p<0,05). A ativação das pastas com AUS proporcionou incremento significativo dos valores de pH (p<0,05). Conclusão: De acordo com a metodologia empregada, pode-se concluir que todas as pastas utilizadas promovem elevação do pH no tecido dentinário, e a ativação das pastas com AUS influencia significativamente na elevação do pH no tecido dentinário (AU).

Objective: The aim of the present study was to evaluate, ex-vivo, the pH elevation capacity on the external root surface of different calcium hydroxide (HC) pastes, utilized as intracanal medication, it was also evaluated the influence of the ultrasonic activation at the application within the root canal. Methods: 100 human single root superior incisors were used, which had their root canals shaped and randomly divided into 6 experimental groups (n=15) according to the following HC pastes: Calen; HC + Chlorhex- idine 2% gel (CX2%); HC + distilled water, utilizing the medications and the ultrasonic activation of the paste at the time of the application as variables and 1 control group (n=10). The teeth were kept immersed in deionized water and the pH parameters were verified in 7, 14, 21 and 28 days with a pH measurement machine. Results: According to the data obtained, pH was elevated in the first week in all groups. Only the groups which the association of HC with CX2% was made, did show a significant increase in the pH level over the analyzed periods (p < 0,05). The activation of the pastes with US provided a significant increase in pH values (p < 0,05). Conclusion: According to the methodology used, we can conclude that all the HC pastes used, promote pH elevation in dentin tissue. And the acti- vation of the pastes with US significantly influences the pH increase in dentin tissue

Endodoncia y ortodoncia. Parte 2: casos clínicos / Endodontics and orthodontics. Part 2: clinical cases

Objetivo: Describir el tratamiento endodóncico de cuatro casos clínicos de reabsorción radicular desarrollada durante o tras un tratamiento ortodóncico. Casos clínicos: Después de la preparación y la desinfección de los conductos radiculares, estos fueron obturados por un tiempo prudencial con una medicación intraconducto de hidróxido de calcio, que luego fue reemplazada por MTA. Luego de un período de entre uno y cuatro años, según el caso, los tratamientos fueron evaluados clínica y radiográficamente. Los dientes que debieron ser extraídos fueron analizados histológicamente. Según la evolución clínica y radiográfica de los casos presentados, el uso inicial de hidróxido de calcio y su posterior reemplazo por MTA parecería ser un protocolo adecuado para completar el proceso de reparación de los tejidos apicales y perirradiculares en casos de reabsorciones radiculares provocadas por fuerzas ortodóncicas excesivas. Las enfermedades sistémicas deben ser tenidas en cuenta para la elección de la terapéutica (AU)

Aim: To describe the endodontic treatment of four clinical cases of permanent teeth suffering root resorption during or after orthodontic treatment. Clinical cases: Four clinical cases of permanent teeth with root resorption were endodontically treated. After the root canals were prepared and disinfected, they were medicated with calcium hydroxide. After an appropriate observation period, the canals were finally filled with MTA. The treatment outcomes were clinically and radiographically assessed at an interval between one to four years according to the clinical case. The histological findings of teeth that required extraction was also described. Our clinical and radiographic observations suggest that a temporary filling with calcium hydroxide and further obturation with MTA can provide a favorable intracanal environment for apical and periradicular tissue reparation. The clinician needs a full medical history to be aware of the systemic diseases in patients with root resorption that will be of importance for the proper selection of treatment (AU)

Different techniques for the treatment of teeth with an incomplete root development and pulp necrosis: a systematic review / Diferentes técnicas para o tratamento de dentes com rizogênese incompleta e necrose pulpar: uma revisão sistemática

Introduction: The objective of this systematic review was to compare the apexification techniques of calcium hydroxide (Ca(OH)2), or mineral trioxide aggregate (MTA), with the pulp regeneration technique, using cohort studies, and non-randomized and randomized clinical trials. Methods: The methodology was based on electronic research in the following databases: PubMed, MEDLINE, Google Scholar, SciELO, and LILACS. In addition, a manual search was carried out using the references that were listed in the articles found. Results: A total of 403 potentially eligible studies were found, with seven being included in the inclusion criteria of this systematic review. The seven studies involved a total of 312 teeth. The minimum time of a follow-up period was 12 months. The irrigation solution most used was sodium hypochlorite, for both of the apexification and revascularization techniques. The medication commonly chosen in the apexification groups was Ca(OH)2, with antibiotic triple paste in the revascularization groups. The clinical rate of success in the groups treated with revascularization varied from 76% to 100%, while in the groups treated with apexification, it ranged from 68% to 100%. Only two studies reached a success rate equal to 100%. Conclusions: Variable levels of evidence were observed in relation to the treatments. However, it was confirmed that revascularization is an excellent option since its outcomes produced a greater gain of thickness and root length, besides developing a decrease in the apical foramen.

Introdução: O objetivo desta revisão sistemática foi comparar as técnicas de apexificação, com hidróxido de cálcio (Ca(OH)2) ou agregado trióxido mineral (MTA), com a técnica de regeneração pulpar, utilizando estudos coorte, ensaio clínico não randomizado e randomizado. Métodos: A metodologia foi baseada em pesquisa eletrônica nas seguintes bases de dados: PubMed, MEDLINE, Google Acadêmico, SciELO e LILACS. Além disso, foi realizada uma pesquisa manual utilizando as referências listadas nos artigos encontrados. Resultados: Foram encontrados 403 estudos potencialmente elegíveis, sendo sete incluídos nos critérios de inclusão desta revisão sistemática. Os sete estudos envolveram um total de 312 dentes. O tempo mínimo de um período de acompanhamento foi de 12 meses. A solução de irrigação mais utilizada foi o hipoclorito de sódio, para as técnicas de apexificação e revascularização. O medicamento comumente escolhido nos grupos de apexificação foi o Ca(OH)2, com pasta tripla antibiótica nos grupos de revascularização. A taxa clínica de sucesso nos grupos tratados com revascularização variou de 76% a 100%, enquanto nos grupos tratados com apexificação variou de 68% a 100%. Apenas dois estudos atingiram uma taxa de sucesso igual a 100%. Conclusões: Níveis variáveis de evidência foram observados em relação aos tratamentos. No entanto, confirmou-se que a revascularização é uma excelente opção, pois seus desfechos produzem maior ganho de espessura e comprimento radicular, além de diminuir o forame apical.