Endodontic treatment during pregnancy: case series and literature review

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.

Atendimento odontológico a pacientes gestantes

“…(Almeida et al, 2019;Ather et al, 2020) A infecção endodôntica constitui-se de um processo polimicrobiano em que a variabilidade do microbioma endodôntico e suas complexas interações com o organismo hospedeiro não apenas conferem um desafio único ao tratamento como também representam Brazilian Journal of Health Review, Curitiba, v. 6, n. 5, p. 26511-26521, sep./oct., 2023 uma possível ameaça para a manifestação de doenças sistêmicas e desfechos adversos na gravidez. (Araújo et al, 2022) Caso não seja tratada nos estágios iniciais, a infecção endodôntica pode escalar para uma periodontite apical crônica, uma sequela dinâmica da infecção do canal radicular. Ela é impulsionada por inflamação localizada persistente dentro do tecido periapical que pode levar à reabsorção óssea progressiva e à formação de lesões periapicais.…”

“…Torna-se válido ressaltar que tratamentos odontológicos invasivos devem ser realizados no segundo trimestre de gestação, contudo a dor de origem dentária deve ser eliminada independentemente no período de gestação. (Araújo et al, 2022) A condição física da gestante pode impedir a realização convencional do tratamento endodôntico. No entanto, a utilização de instrumentação mecânica para o preparo do canal radicular, combinada ao emprego de um localizador eletrônico de ápice para reduzir a exposição à radiação, bem como técnicas simplificadas de obturação utilizando um único cone, possibilita a execução do tratamento endodôntico em menor tempo clínico, melhorando as condições de trabalho tanto para o profissional quanto para a paciente.…”

Knowledge, Attitude, and Practice Regarding Periodontal and Dental Diseases During Pregnancy Among Obstetricians and Dentists in King Saud University Medical City

“…To provide adequate preventative and therapeutic care to pregnant patients and obstetricians, dentists must acknowledge and understand this condition to a sufficient degree. Additionally, pregnancy is not a reason to postpone endodontic treatment, but its management requires certain considerations, such as adjusting the timing and dosing of treatments and other interventions that need to be provided [13,14]. An accumulation of evidence suggests a link between periodontal disease, also known as inflammatory gum disease, and adverse pregnancy outcomes such as preterm birth, low birth weight, and preeclampsia [15].…”