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

Abstract

The pulp tissue is the one that helps the formation of the root tissue through the odontoblasts that produce dentin, which is sometimes affected by trauma, carious lesions and carious lesions. Trauma in permanent teeth is common and can disturb up to 30% of children. A tooth diagnosed with an immature apex and irreversible pulpitis is not advisable to fill the canal until the apex is closed because it can be affected due to the thinness of the root walls causing immediate or mediate future fracture, this being a challenge for the professional, there are different treatments that help us to stimulate root development, these can be apicoforming and apigenesis. Regenerative endodontics is a novel modality that helps the physiological replacement of damaged tooth structures such as dentin, root and pulp-dentin complex cells. In 1961 ostby wrote the revascularization procedure for the first time, he mentioned that the new vascularized tissue can induce the development of apex in teeth with irreversible pulpitis. Demonstrating the importance of the formation of a coagulum, which has the function of base or scaffold and support the new tissue to be formed; also in 1966 he emphasized the need to disinfect the canal with an antibiotic paste at the time of apexification. The use of calcium hydroxide is described to establish a hard apical wall in the dental tissue, where it facilitates the placement of obturator material inside the root canal of the tooth to be treated, through a series of steps in the treatment with calcium hydroxide, it is important to note that in this type of treatment we will need local anesthetic, as well as the use of the rubber dam thus providing access to the root conductor of the dental piece. Bioceramics are materials that are structured by tricalcium silicate, bismuth oxide, calcium phosphate and silicon oxide, they are biocompatible, antibacterial, radiopaque, have easy handling, they are also dimensionally stable and as an important point they will not be affected by blood contamination, they will also help us in an apical sealing; These materials cure in humid environments and have good resistance to compression with a very low toxicity, they have a short treatment time which will help both the clinician and the patient to reduce stress time.