Calcificación pulpar en dientes traumatizados: una revisión de la literatura

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i7.29293

Palabras clave:

Traumatismos de los Dientes; Calcificaciones de la Pulpa Dental; Necrosis de la pulpa dental.

Resumen

Los traumatismos dentarios son situaciones que se presentan con frecuencia en la población, la prevalencia es mayor en el sexo masculino, en edad escolar o deportistas. Dependiendo de la gravedad del traumatismo pueden surgir complicaciones que deben ser correctamente diagnosticadas y tratadas. Tales complicaciones incluyen necrosis pulpar, reabsorción radicular externa o de reemplazo y calcificaciones de la cámara pulpar. La obliteración del conducto radicular o metamorfosis calcificante se caracteriza por el depósito de tejido duro en el espacio pulpar, que puede verse radiográficamente, y por la coloración amarillenta de la corona dental. En algunos casos puede asociarse a necrosis pulpar y presencia de lesión periapical, pudiendo considerarse complejo el tratamiento. La mayoría de las calcificaciones pulpares son asintomáticas y se clasifican según su localización y morfología. El principal método de diagnóstico ha sido a través de radiografías intraorales y panorámicas, aunque la tomografía computarizada de haz cónico (cbct) ofrece mejores detalles. Por lo tanto, el objetivo de este estudio fue revisar la literatura sobre los patrones de calcificación pulpar más frecuentemente reportados en la literatura científica relacionada con el trauma dental, con el fin de ayudar al profesional en la orientación, diagnóstico, planificación del tratamiento y pronóstico adecuado.

Biografía del autor/a

Hebertt Gonzaga dos Santos Chaves, Universidade Federal de Minas Gerais

Cirujano dentista, especialista e estudante de Maestria em Endodontia da Faculdade de Odontologia da Universidade Federal de Minas Gerais (UFMG).

Trabalho na linha de investigação: Inmunopatologia e microbiologia das enfermedades bucodentais. Sua linha de investigação trata principalmente dos seguintes temas: Biocompatibilidade de biomateriais, respostas imunológicas e microbiológicas em tecidos pulpares e periapicais, recubrimiento pulpar, pulpotomía, resposta pulpar e medicação intracanal.

Citas

Amir, F.A., Gutmann, J. L. & Witherspoon, D. E. (2001). Calcific metamorphosis: a challenge in endodontic diagnosis and treatment. Quintessence International. 32(6), 447-455.

Anderson, J; Wealleans, J; & Ray J. (2018). Endodontic applications of 3D printing. International Endodontic Journal. 51, 1005-1018.

Andreasen, F. A. & Andreasen J. O. (2001). Texto e atlas colorido de traumatismo dental. Artmed Editora Ltda.

Andreasen, F. M., Zhijie, Y., Thomsen, B. L., & Andersen, P. K. (1987). Occurrence of pulp canal obliteration after luxation injuries in the permanent dentition. Endodontic Dental Traumatology. 3(3), 03-115.

Andreasen, J. (1970). Luxation of permanent teeth due to trauma. Scandinavian Journal of Dental Research. 78(1-4), 273-286.

Andreasen, J. O. (1987). Experimental dental traumatology: development of a model for external root resorption. Endod Dent Traumatol. 3(6), 269-87.

Bastos, J. V & Cortes, M. I. S. (2018). Pulp canal obliteration after traumatic injuries in permanent teeth – scientific fact or fiction. Brazilian Oral Research. 32(1), 159-168.

Bourguignon, C., Cohenca, N., Lauridsen, E., Flores, M. T., O'Connell, A. C., Day, P. F. et al. (2020). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 36(4), 314-330.

Buchgreitz, J., Buchgreitz, M. & Bjørndal, L. (2019). Guided root canal preparation using cone beam computed tomography and optical surface scans - an observational study of pulp space obliteration and drill path depth in 50 patients. Int Endod J. 52(5), 559-568.

Casadei, B. de A., Lara-Mendes, S. T. de O., Barbosa, C. de F. M., Araujo, C.V., Freitas, C.A., Machado, V.C., Santa-Rosa, C.C. (2019). Access to original canal trajectory after deviation and perforation with guided endodontic assistance. Australian Endodontic Journal. 46, 101-106.

Connert, T. et al. (2018). Microguided endodontic treatment method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided technique. International Endodontic Journal. 51, 247-255.

Connert, T., Krug, R. & Eggmann, F. et al. (2019). Guided Endodontics versus Conventional Access Cavity Preparation: A Comparative Study on Substance Loss Using 3-dimensional–printed Teeth. Journal of Endodontics. 45(3), 327-331.

Connert, T., Krug, R., Eggmann, F., Emsermann, I., Elayouti, A., Weiger, R. K. S., Krastl, G. (2019). Guided endodontics versus conventional access cavity preparation: a comparative study on substance loss using 3dimensional–printed teeth. Journal Of Endodontics. 45(3).

Costa, C. A. S. & Merzel, J. (1994). Biological compatibility of resorcin-formaldehyde resin: histological valuation of your effects on dentin in rats. Rev. odontol. UNESP. 23(1), 21-28.

Cvek, M., Granath, L. & Lundberg, L. (1982). Failures and healing in endodontically treated non vital anterior teeth with post traumatically reduced pulpal lumen. Acta Odontológica Scandinavia. 40(4), 223-228.

De Cleen, M. (2002). Obliteration of pulp canal spaces after concussion and subluxation: endodontic considerations. Quintessence International. 33(9), 661-669.

De Deus Q. D. (1992). Alterações da Polpa Dental, Sessão 3: Alterações pulpares. Endodontia. Medsi.

Delivanis, H. P & Sauer, G. J. R. (1982). Incidence of canal calcification in the orthodontic patient. American Journal of Orthodontics. 82(1), 58-56.

Dodds, R., Holcomb, J. & Mcvicker, D. (1985). Endodontic management of teeth with calcific metamorphosis. Compendium of Continuing Education Dentistry. 6(1), 515-20.

Du, Y., Wei, X. & Ling, J. Q. (2022). Application and prospect of static/dynamic guided endodontics for managing pulpal and periapical diseases. Zhonghua Kou Qiang Yi Xue ZaZhi. 57(1), 23-30.

Estrela, C. et al. (2018). Root perforations: a review of diagnosis, prognosis and materials. Braz Oral Res. 32(1), 133-146.

Ferreira, D. A. B., Costa, L. B. M., Melgaço, J. L. B., Basto, J. V. (2012). Alterações Pulpares com o envelhecimento. In: Endodontia: uma visão contemporânea. São Paulo: Editora Santos.

Goga, R., Chandler, N. P. & Oginni, A. O. (2008). Pulp stones: a review. International Endodontic Journal. 41(6), 457-468.

Gregorio, C., Cohenca, N., Romano, F., Pucinelli, C. M., Cohenca, N., Romero, M. et al. (2018). The effect of immediate controlled forces on periodontal healing of teeth replanted after short dry time in dogs. Dent Traumatol. 34(1), 336-46.

Gröndahl, G. & Huumonen, S. (2004). Radiographic manifestations of periapical inflammatory lesions. How new radiological techniques may improve endodontic diagnosis and treatment planning. Endodontic Topics. 8(1), 55-67.

Hargreaves, K. M. & Goodis, H. E. (2009). Polpa dentária de Seltzer e Bender. Di Livros Editora Ltda.

Holcomb, J. & Gregory W. (1967). Calcific metamorphosis of the pulp. Its incidence and treatment. Oral Surgery Oral Medicine Oral Pathology. 24(6), 825-830.

Ishak, G., Habib, M., Tohme, H., Patel, S., Bordone, A., Perez, C., & Zogheib, C. (2020). Guided endodontic treatment of calcified lower incisors: a case report. MDPI. Journal Dentistry. 8(74).

Ito, K. et al. (2015). Hypoxic condition promotes differentiation and mineralization of dental pulp cells in vivo. International Endodontic Journal. 48(1), 115–123.

Jacobsen, I. & Sangnes, G. (1978). Traumatized primary anterior teeth. Prognosis related to calcific reactions in the pulp cavity. Acta Odontol Scand. 36(4), 199-204.

Keleş, A., Keskin, C. & Versiani, M. A. (2022). Micro-CT assessment of radicular pulp calcifications in extracted maxillary first molar teeth. Clin Oral Investig. 26(2), 1353-1360.

Kim, S. & Kratchman, S. (2006). Modern endodontic surgery concepts and practice. Journal of Endodontics. 32(1), 601-32.

Kim, S. (1985). Ligamental injection: a physiological of its efficacy. J Endod. 12(1), 486–91.

Krastl, G., Weiger, R., Filippi, A., Van Waes, H., Ebeleseder, K., Ree, M., Connert, T., Widbiller, M., Tjäderhane, L., Dummer, P. M. H., & Galler, K. (2001). Endodontic management of traumatized permanent teeth: a comprehensive review. Int Endod J. 54(8), 1221-1245.

Krastl, G., Zehnder, M. S., Connert, T., Weiger, R., K€Uhl, S. (2016). Guided endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology - case report. Dental Traumatology. 32(1), 240-246.

Kuyk, J. K. & Walton, R. E. (1990). Comparison of the radiographic appearance of root canal size to its actual diameter. Journal of Endodontics. 16(11), 28-33.

Kvinnsland, I., Oswald, R. J., Halse, A., & Grønningsaeter, A. G. (1989). A clinical and roentgenological study of 55 cases of root perforation. International Endodontic Journal. 22(2), 75-84.

Lara-Mendes, S. T. O. et al. (2018). A New Approach for Minimally Invasive Access to Severely Calcified Anterior Teeth Using the Guided Endodontics Technique, JOE. 44(10), 1578-1582.

Lauridsen, E., Gerds, T. & Andreasen, J. O. (2016). Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture. Dent Traumatol. 32(1), 128-139.

Leonari, D. P.et al. (2011). Alterações pulpares e periapicais. RSBO. 8(4), 47-61.

Li, L. et al. (2011). Hypoxia Promotes Mineralization of Human Dental Pulp Cells. JOE. 37(6), 799-802.

Luukko, K. et al. (2011). Estrutura e Funções do Complexo Dentino-Pulpar. In: COHEN. Caminhos da Polpa. Elsevier.

Malhotra, N. & Mala, K. (2013). Calcific metamorphosis. Literature review and clinical strategies. Dent Update. 40(1), 48-50, 53-4, 57-8.

Marcano Caldeiro, M., Mejia Cardona, J. L., Parra Sanchez, J. H., Mendez de la Espriella, C., Covo Morales, E., Sierra Varon, G. et al. (2018). Knowledge about emergency dental trauma management among school teachers in Colombia: a baseline study to develop an education strategy. Dent Traumatol. 34(1), 64-74.

McCabe, P. S. & Dummer, P. M. (2012). Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Int Endod J.45(2), 177-97.

Mello-Moura, A. C. V., Santos, A. M. A., Bonini, G. A. V. C., Zardetto, C. G. D. C., Moura-Netto, C., & Wanderley, M. T. (2017). Pulp Calcification in Traumatized Primary Teeth - Classification, Clinical and Radiographic Aspects. J Clin Pediatr Dent. 41(6), 467-471.

Mileski, T., Félix, B. B., Pini, N. I. P., Lima, F. F., Mori, A. A., & Neto, D. S. (2018). Internal bleaching on traumatized tooth: a clinical case report. Rev. Uningá, Maringá. 55(2), 24-32.

Moura, L. B., Velasques, B. D., Silveira, L., Martos, J., & Xavier, C. B. (2017). Therapeutic Approach to Pulp Canal Calcification as Sequelae of Dental Avulsion. European endodontic journal. 2(1), 1-5.

Nanci, A. (2013). Ten Cate’s Oral Histology. Mosby.

O’Connor, R. P., Demayo, T. J. & Roahen, J, O. (1994). The lateral radiograph: an aid to labiolingual position during treatment of calcified anterior teeth. Journal of Endodontics. 20(4), 183-184.

Oginni, A. O., Adekoya-Sofowara, C. A. & Kolawole, K. A. (2009). Evaluation of radiographs, clinical signs and symptoms associated with pulp canal obliteration: an aid to treatment decision. Endodontics and Dental Traumatology. 25(6), 620-625.

Orikasa, S., Kawashima, N., Tazawa, K., Hashimoto, K., Sunada-Nara, K., Noda, S., Fujii, M., Akiyama, T., Okiji, T. (2022). Hypoxia-inducible factor 1α induces osteo/odontoblast differentiation of human dental pulp stem cells via Wnt/β-catenin transcriptional cofactor BCL9. Sci Rep. 12(1), 682.

Patel, M., Kesharmi, P.R., Shah, K.P., Patel, N.K., Shah, S. (2020). Microguided endodontics: A novel treatment approach for teeth with pulp canal calcifation and apipcal periodontitis. International Journal of Scientific Research. 9, 2277-8179.

Patersson, S. S. & Mitchell, D. F. (1965). Calcific metamorphosis of the dental pulp. Oral Surgery Oral Medicine Oral Pathology. 20(1), 94-101.

Pettiette, M. T. et al. (2013). Potential Correlation between Statins and Pulp Chamber Calcification. J Endod. 39(9), 1119-23.

Pujol, M. L., Vidal, C.; Mercadé, M.; Muñoz, M.; & Ortolani-Seltenerich, S. (2021). Guided Endodontics for Managing Severely Calcified Canals. J Endod. 47(2), 315-321.

Ribeiro, F.H.B., Maia, B. das G.O., Verner, F. S., & Junqueira, R.B. (2020). Aspectos atuais da Endodontia guiada. HU Revista. 46, 1-7.

Robertson, A. (1998). A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries. Endodontic Dental Traumatology. 14(6), 245-256.

Robertson, A., Andreasen, F. M., Andreasen, J. O., & Norén, J. G. (2000). Long-term prognosis of crown-fractured permanent incisors. The effect of stage of root development and associated luxation injury. International Journal of Pediatric Dentistry. 10(3), 191-199.

Robertson, A., Andreasen, F. M., Bergenholtz, G., Andreasen, J. O., & Norén, J. G. (1996). Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors. J Endod. 22(10), 557-60.

Santiago, M. C., Altoe, M. M., de Azevedo Mohamed, C. P., de Oliveira, L. A., & Salles, L. P. (2022). Guided endodontic treatment in a region of limited mouth opening: a case report of mandibular molar mesial root canals with dystrophic calcification. BMC Oral Health. 22(1), 37.

Satheeshkumar, P. S. et al. (2013). Idiopathic dental pulp calcifications in a tertiary care setting in South India. Journal of Conservative Dentistry: JCD. 16(1), 50-5.

Shi, X., Zhao, S., Wang, W., Jiang, Q., & Yang, X. (2017). Novel navigation technique for the endodontic treatment of a molar with pulp canal calcification and apical pathology. Australian Endodontic Journal. 44(1), 66-70.

Shokri, A., Mortazavi, H., Salemi, F., Javadian, A., Bakhtiari, H., & Matlab, H. (2013). Diagnosis of simulated external root resorption using conventional film radiography, CCD, PSP, and CBCT: a comparison study. Biomedical Journal. 36(1), 18-22.

Siddiqui, S. H. & Mohamed, A. N. (2016). Calcific Metamorphosis: A Review. Int J Health Sci (Qassim). 10(3), 437-42.

Silva, P.Á.C, Silva, I. S. N. (2019). Acesso endodôntico minimamente invasivo: Revisão de Literatura. SALUSVITA, Bauru, 2019.

Soares Ade, J., Gomes, B. P., Zaia, A. A., Ferraz, C. C., & de Souza-Filho, F. J. (2008). Relationship between clinical-radiographic evaluation and outcome of teeth replantation. Dent Traumatol. 24(20), 183-8.

Soares, I. J. & Goldberg, F. (2011). Endodontia: técnicas e fundamentos. ArtMed.

Souza, C. R., Augusto, C. R., de Aquino, E. P., Alves, J. C., & Pires, R. P. (2017). Venâncio GN. Reabilitação estética de dente anterior escurecido: relato de caso. Archives of health investigation. 6(8), 377-381.

Tavares, W. L. F. et al. (2018). Guided Endodontic Access of Calcified Anterior Teeth. J Endod. 44(1), 1195-1199.

Tavares, W. L. F., Pedrosa, N. O. M., Moreira, R. A., Braga, T., Machado, V. C., Sobrinho, A. P. R., & Amaral, R. R. (2022). Limitations and Management of Static-guided Endodontics Failure. J Endod. 48(2), 273-279.

Torabinejad, M., Walton, R. E. & Fouad, A. F. (2015). Endodontics: principles and practice. Elsevier.

Torneck, C. (1990). The clinical significance and management of calcific pulp obliteration. Alpha Omegan. 83(4), 50-54.

Torres, A. et al. (2019). Microguided Endodontics: a case report of a maxillary lateral incisor with pulp canal obliteration and apical periodontitis. International Journal of Endodontics. 52(1), 540-549.

Van Der Meer, W. J., Vissink, A., Ng, Y. L., & Gulabivala, K. (2016). 3D computer aided treatment planning in endodontics. Journal of Dentistry. 45(1), 67-72.

Vaz, I. P. et al. (2011). Tratamento em incisivos centrais superiores após traumatismo dental. Rev. gaúch. odontol. 59(2), 305-311.

Villa-Machado, P. A., Restrepo-Restrepo, F. A., Sousa-Dias, H., & Tobón-Arroyave, S. I. (2022). Application of computer-assisted dynamic navigation in complex root canal treatments: Report of two cases of calcified canals. Aust Endod J. 00, 1–10.

Vitali, F. C., Cardoso, I. V., Mello, F. W., Flores-Mir, C., Andrada, A. C., Dutra-Horstmann, K. L., & Duque, T. M. (2021). Association between Orthodontic Force and Dental Pulp Changes: A Systematic Review of Clinical and Radiographic Outcomes. J Endod. 48(3), 298-311.

Wang, G., Wang, C. & Qin, M. (2019). A retrospective study of survival of 196 replanted permanent teeth in children. Dent Traumatol. 35(4-5), 251-258.

Publicado

28/05/2022

Cómo citar

CHAVES, H. G. dos S. .; MOREIRA, T. P. C. .; FIGUEIREDO, B.; MACEDO, I. F. A.; FERREIRA, I. da C.; MAIA, C. A. .; MAIA, G. A. .; FERREIRA, G. da C.; SILVA, V. J. de L.; NASCIMENTO, W. M. Calcificación pulpar en dientes traumatizados: una revisión de la literatura. Research, Society and Development, [S. l.], v. 11, n. 7, p. e36011729293, 2022. DOI: 10.33448/rsd-v11i7.29293. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29293. Acesso em: 1 jul. 2024.

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Ciencias de la salud