Hidróxido de cálcio como material obturador em pulpectomias de dentes decíduos anteriores superiores – ensaio clínico randomizado

Abstract

The performance of pulpectomies in anterior primary teeth in an extremely young and immature population is a critical issue because, in addition to safety and aesthetics, the root filling material also requires efficacy presented within the shortest possible clinical time, so that the treatment positively interferes the child development. The aim of the present study was to evaluate the endodontic treatment of superior anterior primary teeth as well as clinical and radiographic success rates when performed in one or two sessions. This randomized, controlled, double-blind clinical trial included a sample comprising patients between 2 and 5 years of age who sought the Pediatric Dentistry unit of the Federal University of Santa Maria (UFSM - Brazil) and who required endodontic treatment of the anterior upper primary teeth. Endodontic treatment were performed using the calcium hydroxide paste as the obturator material, in which group 1 was treated in one session and group 2 in two. Clinical and radiographic evaluations were performed at 1, 2, 3, 6, 12 and 18 months, by an expert examiner (kappa>0.84). The pulpectomy survivals were analyzed by the Kaplan-Meier estimation and COX Regression (p <0.05). 80 pulpectomies were performed in 36 patients (66.66% boys and mean age 4.08 years), with a mean survival estimated at 17 months of follow-up. At 12 months, the survival rate reached 88%. For the radiographic outcome, 18.75% presented failure, and 17.5% belonged to group 2 (p = 0.02). For the clinical outcome, only 7.5% presented fistula (p = 0.16). Calcium hydroxide-based paste may obtain satisfactory results when employed in a single session for pulpectomy of superior anterior deciduous teeth, which may achieve a radiographic success rate of 81.25%. The use of a second session to perform the exchange of the obturator material had a negative effect and lack of results.