Biocompatibilidade em pulpotomia de dentes decíduos: melhor material e alternativas ao uso do MTA: revisão sistemática e meta-análise
DOI:
https://doi.org/10.34019/1982-8047.2023.v49.40598Palavras-chave:
Agentes de Capeamento da Polpa Dentária e Pulpectomia, Materiais Biocompatíveis, PulpotomiaResumo
Introdução: A terapia pulpar vital é o tratamento que visa a manutenção da vitalidade pulpar e da função do dente. Para a pulpotomia, os materiais são escolhidos baseados em algumas características fundamentais, tais como a biocompatibilidade e bioatividade. Atualmente, o Agregado de Trióxido Mineral (MTA) é o mais comumente utilizado para este procedimento. Objetivo: Identificar o melhor material para uso em pulpotomia em dentes decíduos considerando a propriedade de biocompatibilidade, através de revisão sistemática da literatura e metanálise. Material e Métodos: A pergunta norteadora foi: “Qual é o melhor agente para pulpotomia em termos de biocompatibilidade?”. Foi realizada pesquisa nas bases de dados eletrônicas Medline/PubMed, SciELO, LILACS e Web of Science sem restrição de data inicial até outubro de 2020, usando os seguintes descritores padronizados pelo Medical Subject Headings (MeSH): “pulpotomy”, “pulp therapy”, “biomaterials”, “biocompatible materials”, “pulp capping agent”, “pulp capping materials”. Resultados: Um total de 358 estudos foram identificados, sendo 15 deles selecionados para análise qualitativa e seis para metanálise. A revisão avaliou aspectos clínicos, radiográficos e histológicos, considerando diferentes períodos de acompanhamento, amostras e metodologias. Diversos materiais foram encontrados e o MTA foi o mais frequente. Embora os resultados qualitativos tenham sido pouco conclusivos em relação ao melhor deles, foi possível estabelecer que o Cimento Portland é uma alternativa viável para a substituição do MTA. Conclusão: A metanálise demonstrou que o MTA é o material mais favorável para uso em pulpotomias em dentes decíduos.
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