Tratamientos para el manejo de dientes permanentes inmaduros con pulpitis reversible.

Abstract

To maintain pulp vitality and the permanence in the mouth of teeth with reversible pulp lesions, it is necessary for the dentist to know the therapeutic options for managing this clinical situation; this includes immature teeth that require stimulating the formation and closure of the apex. The objective was to analyze the treatments used for the management of immature permanent teeth with reversible pulpitis. A systematic review was carried out that included 10 articles published between 2017 and 2023. To decide the treatment to be performed on immature permanent teeth with reversible pulpitis, it is necessary to consider the size of the pulp exposure and the time that has elapsed since the produced. Apexogenesis can be performed by direct pulp capping or a superficial partial biopulpectomy. Available materials include MTA, Biodentine, PRF, nanohydroxyapatite, triple antibiotic paste, calcium-enriched mixtures, and classic calcium hydroxide. All have been shown to be effective, but the largest number of studies support that the highest success rates are found in MTA and Biodentine. Protocols include taking a diagnostic periapical radiograph, use of local anesthesia, isolation of the operative field with the rubber dam, and disinfection of the tooth with an antiseptic, such as chlorhexidine. After that, it varies depending on whether a direct pulp capping or a superficial partial biopulpectomy will be performed. In any case, the selection material should be MTA or a similar cement. The tooth is then reconstructed with ionomeric glass or resin, and clinical and radiographic checks are performed periodically.