Endodontic treatment of the deciduous tooth [Il trattamento endodontico del dente deciduo]

OBJECTIVES Carious pathology has a progres-sively degenerative trend which in the absence of adequate treatment can lead to injure the pulp organ, imposing an endodontic approach to the dental element. The aim of this work is to provide the clinical indications, the methods to be undertaken in the end-odontic treatment of the primary teeth, as well as the choice of the most suitable materials, in order to obtain predictable therapeutic results and safeguard the integrity of the elements involved. MATERIALS AND METHODS Endodontic treatment of the primary teeth basically provides two types of procedures: pulpotomy and pulpectomy. Pulpotomy is the endodontic treatment indicated for dental elements where there is exposure of the pulp organ following the re-moval of infected tissue, or con-sequently to a trauma. To carry out the aforementioned treatment it is necessary that the dental elements involved do not show signs of pulp suffering, neither clinical nor radiographic. The pulpotomy procedure involves the removal of the dental tissue affected by carious lesion, the opening of the pulp chamber and the removal of the chamber pulp tissue. Subse-quently, the most suitable material is applied in contact with the root pulp, and finally coronal reconstruction is performed. The purpose of this treatment is to preserve the vitality of the root pulp by promoting a physiological rizalysis process in order to ensure the maintenance of the dental arch space. Pulpectomy is a treatment that involves the removal of the entire pulp organ, both coronal and ra-dicular, and is indicated in cases where the pulp is irreversibly in-flamed or non-vital due to ad-vanced carious lesions or trauma. Following the cavity cleaning and the chamber opening, we pro-ceed, after detecting the working length with the electronic apex lo-cator, with the instrumentation and disinfection of the endodontic space. Subsequently, the root canal obturation is performed, with a material that does not hinder physiological rizalysis, and coronal reconstruction. The purpose of pulpectomy is to control the infec-tion, eliminate the pathogenic bacteria from the root canal sys-tem and maintain the space in the dental arch to ensure the correct eruption of the corresponding permanent dental element. RESULTS The pulpotomy treatment allows a conservative approach to the primary teeth, ensuring a high thera-peutic success thanks also to the current materials available on the market. Pulpectomy allows the elimination of the bacterial load and the consequent regression of ongoing diseases, ensuring the permanence of the primary teeth up to the physiological exchange. CONCLUSIONS Currently, the pediatric dentist can perform predictable therapies and maintain the primary teeth up to physiological exfoliation thanks to the innovative materials and techniques available. All this guaran-tees the improvement of the oral health of the child and a harmoni-ous growth of the stomatognathic system.