Remoção seletiva de tecido cariado e proteção pulpar indireta: relato de casos clínicos
Relato de casos clínicos
DOI:
https://doi.org/10.5335/rfo.v26i1.11815Palavras-chave:
Cárie dentária. Forramento de cavidade dentária. Restauração dentáriaResumo
Objetivo: este artigo se propõe a discutir o tratamento de lesões profundas de cárie em molares permanentes,
através da técnica de remoção seletiva de tecido cariado e restauração de resina composta, em dois casos
clínicos, utilizando apenas sistema adesivo (caso 1) ou proteção pulpar indireta com cimento de hidróxido
de cálcio (caso 2). Relato de casos: os indivíduos foram diagnosticados com dentes apresentando lesões
profundas de cárie, isto é, com mais de 50% em profundidade da dentina, confirmada pelo exame radiográfico interproximal. O conjunto de resultados de testes de sensibilidade pulpar positivo ao frio e teste de
percussão horizontal e vertical negativos, juntamente com a ausência de dor espontânea e normalidade do
periápice (radiografia periapical), completaram os requisitos exigidos para execução da técnica de remoção
seletiva de dentina cariada amolecida. Os dentes receberam restaurações adesivas na mesma sessão, sobre
a dentina cariada amolecida da parede pulpar que havia recebido forramento de cimento de hidróxido de
cálcio ou não, dependentes de uma randomização. Ambos os casos apresentados mostraram sucesso clínico
em acompanhamento de 18 meses, tanto na manutenção da vitalidade pulpar quanto na sobrevivência da
restauração. Considerações finais: com base nos casos apresentados, sabendo das limitações deste modelo
de estudo, e em concordância com a literatura, a remoção seletiva de tecido cariado pode ser executada com
sucesso no tratamento de lesões profundas de cárie, respeitando-se todos os passos da técnica, e parece não
haver necessidade de uso de proteção pulpar indireta.
Palavras-chave: cárie dentária; forramento de cavidade dentária; restauração dentária.
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