Eficacia clínica del MTA en Pulpotomías de pacientes pediátricos: Una Revisión Sistemática

Sol Gabriela Holguin Garcia

doi:10.47990/alop.v11i1.228

Authors

Sol Gabriela Holguin Garcia Universidad Laica Eloy Alfaro de Manabí https://orcid.org/0000-0002-3361-6798

DOI:

https://doi.org/10.47990/alop.v11i1.228

Keywords:

MTA, pulpotomy, clinical efficiency

Abstract

Objective: To analyze the clinical efficacy of the Mineral Trioxide Aggregate (MTA) in pulpotomies through comparative studies with formocresol, ferric sulfate, and calcium hydroxide; in pediatric patients aged three to nine years. Materials and Methods: The article is based on a systematic review of the literature, therefore, databases were used as sources of information: PubMed, Scielo, and Virtual Health Library. Likewise, as inclusion criteria, publications from 2008 to 2019 were established, whose origin was derived from journals and refereed academic journals; which allowed us to obtain sixteen trials that evaluated clinical efficacy through the signs and symptoms of the most common pulp diseases: abscess, gingival inflammation, pathological mobility, pain on percussion and spontaneous pain. Results: MTA obtained an efficacy of 97.9% as opposed to 86.9% for ferric sulfate. Concerning Formocresol, MTA achieved 99% versus 98.3% efficacy. Also, in the comparison of MTA with Calcium Hydroxide, the former achieved 98.2% and the latter 74.5%. Conclusions: MTA obtained a higher clinical efficacy due to its biocompatibility, basic pH, and its high faculty when sealing the pulp chamber. Therefore, it can be used as a safe material for pediatric patient pulpotomies.

References

Odabas M, Bodur H, Baris E, Demir C. Clinical, Radiographic, and Histopathologic Evaluation of Nd: YAG Laser Pulpotomy on Human Primary Teeth. J Endod [Internet]. 2007 [Consultado 2019 Jun 10]; 33: 415-21. Disponible en: https://www.jendodon.com/article/S0099-2399(06)01221-0/fulltext

IARC Classifies Formaldehyde As Carcinogenic To Humans. IARC Monogr Eval Carcinog Risks Hum [Internet]. 2006 [Consultado 2019 May 10]; 62:217–375 Disponible en: https://monographs.iarc.fr/wp-content/uploads/2018/06/mono88.pdf

Zaror C, Vergara C, Díaz J, Aracena D. Pulpotomías con sulfato férrico y MTA en dientes primarios: serie de casos. Int. J. Odontostomat [Internet]. 2011 [Consultado 2019 Jun 2]; 5(1):77-82. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0718-381X2011000100012

Srinivasan V, Patchett CL, Waterhouse PJ. Is there life after Buckley´s Formocresol? Part I – A narrative review of alternative interventions and materials. Int J Paed Dent [Internet]. 2006 [Consultado 2019 Jun 10]; 16: 117-27. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/16430526

Assed S, Assed L, Nelson-Filho P. Pulpotomía en dientes temporales y permanentes jóvenes. En: Assed L, editor. Tratado de Odontopediatría. 1 ed. Colombia: Amolca; 2008. 571-611.

Biedma M, Solano B, García F, Mendoza A, Iglesias A. Clinical and radiographic evaluation of white MTA versus formocresol Pulpotomy: a 48-month follow-up study. Am J Dent [Internet]. 2017 [Consultado 2019 Jun 2]; 30(3):131-136. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29178757

Valdivieso M, Huamán M. Diagnóstico y tratamiento pulpar. En: Castillo R Perona G, Kanashiro C, Perea M, Silva-Esteves F, editores. Estomatología Pediátrica. 1 ed. España:Ripano “Editorial Médico”; 2011. p. 174-99.

Rodríguez P; Bolaños V. Propiedades y Usos en Odontopediatria del MTA (Agregado de Trióxido Mineral) Odovtos - International Journal of Dental Sciences [Internet]. 2011 [Consultado 2019 Jun 2]; 13, 2011, pp. 65-70 Disponible en: https://revistas.ucr.ac.cr/index.php/Odontos/article/view/4772

Aguado J, Cruz I,Maroto M, Barbería E. (2009). Posibilidades terapéuticas del Agregado Trióxido Mineral (MTA) en odontopediatría. JADA [Internet]. 2009 [Consultado 2019 Jun 2]; 4. 185-193. Disponible en: https://www.researchgate.net/publication/257920006_Posibilidades_terapeuticas_del_Agregado_Trioxido_Mineral_MTA_en_odontopediatria

Hincapié S, Valerio AL. Biodentine: una nueva propuesta en terapia pulpar. Univ Odontol. 2015 [Consultado 2019 May 10]; 34(73): 69-76. Disponible en: https://revistas.javeriana.edu.co/index.php/revUnivOdontologica/article/view/16040

Caicedo R, Abbott P, Alongi D, Alarcon M. Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth. Austr Dent J [Internet]. 2006 [Consultado 2019 Jun 14]; 51(4): 297-305. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/17256303

Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 The Cochrane Collaboration [Internet]. 2011 [Consultado 2019 May 14]. Disponible en: https://es.cochrane.org/sites/es.cochrane.org/files/public/uploads/manual_cochrane_510_web.pdf

Kitchenham B. Procedures for Performing Systematic Reviews. Department of Computer Science, Keele University Technical Report [Internet]. 2004 [Consultado 2019 May 12]; 33. Disponible en: www.inf.ufsc.br/~aldo.vw/kitchenham.pdf

Kitchenham B, Brereton P, Budgen D, Turner M, Bailey J, Linkman S. Systematic literature reviews in software engineering-A systematic literature review. Information and Software Technology [Internet]. 2009 [Consultado 2019 May 12]; 51. 7-15. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0950584908001390

Junqueira M, Cunha N, Caixeta, Marques N, Oliveira T, Moretti A, Cosme L, Sakai V. Clinical, Radiographic and Histological Evaluation of Primary Teeth Pulpotomy Using MTA And Ferric Sulfate. Braz. Dent. J [Internet]. 2018 [Consultado 2019 Jun 2]; 29(2): 159-165. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-64402018000200159&lng=en.

Guven Y, Aksakal S, Avcu N, Unsal G, Tuna E, Aktoren O. Success Rates of Pulpotomies in Primary Molars Using Calcium Silicate-Based Materials: A Randomized Control Trial. Biomed Res Int [Internet]. 2017 [Consultado 2019 Jun 2]; 2017. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29226134

Goyal P, Pandit I, Gugnani N, Gupta M, Goel R, Gambhir R. Clinical and radiographic comparison of various medicaments used for pulpotomy in primary molars: A randomized clinical trial. Eur J Dent [Internet]. 2016 [Consultado 2019 Jun 2]; 10:315-20. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27403046

Yildiz E, Tosun G. Evaluation of formocresol, calcium hydroxide, ferric sulfate, and MTA primary molar pulpotomies. Eur J Dent [Internet]. 2014 [Consultado 2019 Jun 2]; 8:234-40. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24966776

Biondi A, Cortese S, Ortolani A. Pulpotomías en molares primarios evaluación clínica, radiográfica de formocresol o trióxido mineral agregado. Revista de la Facultad de Odontología- Repositorio (UBA) [Internet]. 2008 [Consultado 2019 Jun 2]; 23:54-55. Disponible en: http://od.odontologia.uba.ar/revista/2008vol23num54-55/art2.pdf

Noorollahian H. Comparison of mineral trioxide aggregate and formocresol as pulp medicaments for pulpotomies in primary molars. Br Dent J [Internet]. 2008 [Consultado 2019 Jun 2]; 204(11). Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/18425074

Hugar S, Deshpande S. Comparative investigation of clinical/radiographical signs of mineral trioxide aggregate and formocresol on pulpotomized primary molars. Contemporary clinical dentistry [Internet]. 2010 [Consultado 2019 Jun 2]; 1(3), 146–151. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220100/

Ansari G, Ranjpour M. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2-year follow- up. International Endodontic Journal [Internet]. 2010?[Consultado 2019 Jun 2]; 43(5):413-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20518934

Godhi B, Sood P, Sharma A. Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: An in vivo study. Contemporary clinical dentistry [Internet]. 2011 [Consultado 2019 Jun 2]; 2(4), 296– 301. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22346156

Hugar S, Reddy R, Deshpande S, Shigli A, Gokhale N, Hugar S. In vivo Comparative Evaluation of Mineral Trioxide Aggregate and Formocresol Pulpotomy in Primary Molars: A 60-month Follow-up Study. Contemporary clinical dentistry [Internet]. 2017 [Consultado 2019 Jun 2]; 8(1), 122–127. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426144/

Jayam C, Mitra M, Mishra J, Bhattacharya B, Jana B. Evaluation and comparison of white mineral trioxide aggregate and formocresol medicaments in primary tooth pulpotomy: clinical and radiographic study. J Indian Soc Pedod Prev Dent [Internet]. 2014 [Consultado 2019 Jun 2]; 32(1):13-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24531596

Yildirim C, Basak F, Akgun O, Polat G, Altun, C. Clinical and radiographic evaluation of the effectiveness of formocresol, mineral trioxide aggregate, portland cement, and enamel matrix derivative in primary teeth pulpotomies: a two year follow-up. J Clin Pediatr Dent [Internet]. 2016 [Consultado 2019 Jun 2]; 40(1):14-20. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26696101

Olatosi O, Sote E, Orenuga O. Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: a clinical and radiographic study. Niger J Clin Pract [Internet]. 2015 [Consultado 2019 Jun 2]; 18(2):292-6. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25666010

Moretti A, Sakai V, Oliveira T, Fornetti A, Santos C, Machado M, Abdo R. The effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth. Int Endod J [Internet.] 2008 [Consultado 2019 Jun 2]; 41(7):547-55. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/18479381

De Vasconcelos B , Bernardes R , Cruz S, Duarte M , Padilha M , Bernardineli N , Garcia R , Bramante C , de Moraes I . Evaluation of pH and calcium ion release of new root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. [Internet]. 2009 [Consultado 2019 Jun 2]; 108(1):135-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19451009

Vallejo E, Rosales J. Materiales dentales. En: Boj JR. Odontopediatría. La evolución del niño al adulto joven. Madrid: Ripano editorial médica; 2011. p. 195-210.

Patchett CL, Srinivasan V, Waterhouse PJ. Is there life after Buckley´s formocresol? Part II – Development of a protocol for the management of extensive caries in the primary molar. Int J Paed Dent [Internet]. 2006 [Consultado 2019 Jun 2]; 16: 199-206 Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/16643542

Gonzalez Rodriguez E., Ruiz Linares M. Diagnóstico y tratamiento en dentición temporal. En: Boj JR, Catalá M, García-Ballesta C, Mendoza A. Odontopediatría. 1ª ed. Barcelona: Masson; 2004 p.173-183.

Isassi H, Mendoza M, Padilla C. Estudio clínico de pulpotomía con agregado trióxido mineral en 58 molares primarios. Medigraphic [Internet]. 2012 [Consultado 2019 Jun 10]; Vol. 37. Disponible en: https://www.medigraphic.com/pdfs/oral/ora-2011/ora1137g.pdf

Castillo R, Perona G, Kanashiro C, Perea M, Silva F. Estomatología Pediátrica, Edit. RIPANO Madrid 2010; (174-191).