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Revascularização pulpar com recurso a plasma rico em plaquetas: revisão narrativa
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Abstract(s)
A revascularização pulpar é atualmente considerada a melhor alternativa terapêutica, em substituição às situações clínicas que anteriormente tinham como indicação principal, a apexificação, sessões de troca de hidróxido de cálcio e formação de barreira apical com MTA. O objetivo deste trabalho de revisão narrativa foi avaliar o uso do plasma rico em plaquetas (PRP) como arcabouço para promover a revascularização pulpar em dentes com rizogênese incompleta e necrose pulpar, que apresentam formação apical incompleta. Nessa revisão vamos avaliar a aplicabilidade clínica, vantagens e desvantagens, assim como protocolos clínicos, e ao mesmo tempo tentar responder se o processo que ocorre pode ser chamado de regeneração ou reparação pulpar. Concluímos que o uso do PRP como âncora nessa terapêutica apenas é vantajoso em casos, onde não conseguimos formar o coágulo sanguíneo por estimulação apical, apresenta relação custo-benefício desfavorável, ainda não foi descrito no protocolo padrão para a realização da técnica de PRP, e os estudos são inconclusivos em relação ao tecido formado no interior das paredes radiculares.
Pulp revascularization is currently considered the best therapeutic alternative, replacing clinical situations that previously had apexification, calcium hydroxide exchange sessions and formation of an apical barrier with MTA as the main indication. The aim of this narrative review work was to evaluate the use of platelet-rich plasma (PRP) as a framework to promote pulp revascularization in teeth with incomplete rhizogenesis and pulp necrosis, which present incomplete apical formation. In this review we will assess the clinical applicability, advantages and disadvantages, as well as clinical protocols, and at the same time try to answer whether the process that occurs can be called pulp regeneration or repair. We conclude that the use of PRP as an anchor in this therapy is only advantageous in cases where we are unable to form the blood clot by apical stimulation, presents an unfavorable cost-benefit ratio, has not yet been described in the standard protocol for performing the PRP technique, and studies are inconclusive regarding the tissue formed within the root walls.
Pulp revascularization is currently considered the best therapeutic alternative, replacing clinical situations that previously had apexification, calcium hydroxide exchange sessions and formation of an apical barrier with MTA as the main indication. The aim of this narrative review work was to evaluate the use of platelet-rich plasma (PRP) as a framework to promote pulp revascularization in teeth with incomplete rhizogenesis and pulp necrosis, which present incomplete apical formation. In this review we will assess the clinical applicability, advantages and disadvantages, as well as clinical protocols, and at the same time try to answer whether the process that occurs can be called pulp regeneration or repair. We conclude that the use of PRP as an anchor in this therapy is only advantageous in cases where we are unable to form the blood clot by apical stimulation, presents an unfavorable cost-benefit ratio, has not yet been described in the standard protocol for performing the PRP technique, and studies are inconclusive regarding the tissue formed within the root walls.
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Keywords
Revascularização pulpar Revitalização pulpar PRP Endodontia Pulpal revascularization Pulpal revitalization Endodontics