Endodontic treatment during pregnancy: case series and literature review

Lucas Peixoto De Araújo,Marina Sousa Azevedo,Fernanda Geraldo Pappen,Andréia Drawanz Hartwig,Ana Regina Romano,Samantha Rodrigues Xavier

doi:10.1590/1981-86372022000520190142

Lucas Peixoto De Araújo, Marina Sousa Azevedo + Show 4 more

Open Access

https://doi.org/10.1590/1981-86372022000520190142

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Abstract

ABSTRACT The aim of this paper is to provide a scientific basis for conducting safe root canal treatment in pregnant women, illustrating with case reports treated in the extension project Maternal-Child Dental Care at the Federal University of Pelotas. The scientific bases address the main doubts of professionals when performing prenatal dental care: use of radiographic examination, local anesthetics, prescription of medications, among other essential factors in the care of pregnant women. The assisted pregnant women sought care with dental pain. In two cases symptomatic irreversible pulpitis was diagnosed, while a third was experiencing acute apical periodontitis. Endodontic procedures were performed under controlled and standardized conditions. The root canals were prepared in a single session, using mechanical instrumentation with reciprocating kinematics (Wave One® Gold Primary - Dentsply Sirona), and the root canal length was determined by an electronic apex locator FinePex (Schuster). Root canal filling was performed by the single cone technique with Wave One® gutta-percha points. After endodontic treatment, coronal sealing was performed with composite resin A2 Z350 XT (3M ESPE). The care related to the gestational condition is highlighted, and the patients remain under monitoring. It is concluded that the use of apical locators and mechanical instrumentation, using reciprocating files associated with the single cone obturation technique with a standardized cone for each system, represents advances for the accomplishment of endodontic treatment in pregnant patients due to the shorter clinical time and greater comfort of the procedure.

Highlights

Prenatal oral health plays an important role in the general health and well-being of pregnant women, and is fundamental for the health and well-being of their newborn children [1-2]
It has been shown that pregnant women have a high frequency of dental pain, especially after the first trimester of pregnancy [8], and that hormonal changes may increase the inflammatory condition or predispose to painful pulp symptoms in the gestational period [9]
The objective of this paper is to provide scientific basis to perform endodontic treatment in pregnant women, illustrated with reports of a series of clinical cases conducted in a single session in the extension project Maternal-Child Dental Care (AOMI) of the School of Dentistry of the Federal University of Pelotas (UFPel)

Summary

Introduction

Prenatal oral health plays an important role in the general health and well-being of pregnant women, and is fundamental for the health and well-being of their newborn children [1-2]. Hormonal variations typical of pregnancy have been related to changes in periodontal tissues [3-5], besides other oral changes as tooth mobility and salivary changes [5-6]. Several gestational factors may predispose to a higher occurrence of dental caries, including increased acidity in the oral cavity, poor oral hygiene, cariogenic diet, low salivary pH, vomiting [4-7] and increased frequency of food ingestion due to the decreased physiological capacity of the stomach [1]. It has been shown that pregnant women have a high frequency of dental pain, especially after the first trimester of pregnancy [8], and that hormonal changes may increase the inflammatory condition or predispose to painful pulp symptoms in the gestational period [9]. After a pathogenic aggressor crosses the threshold of physiological tolerance of the pulp, this tissue will respond by an inflammatory reaction to eliminate the aggressive agents [11]

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