DERİN DENTİN ÇÜRÜKLERİNİN TEDAVİSİNDE ALTERNATİF YENİ YÖNTEMLER

Year 2016, Supplement 16, 120 - 136, 24.11.2016

İzgen Hacıoğulları Nuran Ulusoy Esra Cengiz

https://doi.org/10.17567/ataunidfd.290602

Abstract

Günümüzde
modern diş hekimliği kapsamında, diş dokularının maksimum oranda korunması ve
fonksiyon görmesi için minimal invaziv yöntemler uygulanmaktadır. G.V. Black
tarafından tanımlanmış olan geleneksel görüşe bağlı kalınarak uygulanan derin
dentin çürüğü tedavilerinde tüm çürük dokunun uzaklaştırılması, pulpanın
perforasyonuna dolayısıyla endodontik girişimlere ve bazı durumlarda çekime neden
olabilmektedir. Dişin ağızda kalma süresi, fonksiyonu ve prognozu açısından
önemli bir etken olan pulpanın vitalitesinin daha uzun süre korunabilmesi
amacıyla adeziv sistemler ve restoratif materyallerdeki yeni gelişmelerle
günümüzde pek çok yeni tedavi yaklaşımı ve materyal geliştirilmiştir. Bu
derlemede derin dentin çürüğü varlığında çürüğün uzaklaştırılmasındaki selektif
yaklaşımlar, kavitenin dezenfeksiyonu, kuafaj uygulamaları ve derin dentin
çürüğünün tedavisindeki güncel yaklaşımlar tartışılmıştır.

Anahtar Kelimeler:  Aşamalı Çürük Tedavisi, Derin
Dentin Çürüğü, Dezenfeksiyon, Selektif Yaklaşımlar

ALTERNATIVE NEW
METHODS FOR THE TREATMENT OF DEEP DENTINE CARIES  

ABSTRACT 

Currently
minimal intervention techniques are put into practice for the maximum
preservation of tooth structure and function in modern dentistry. While treating
deep dentine caries according to the traditional method defined by G.V. Black,
removing all of the carious tissue can give way to perforation of the pulp,
endodontic treatment or at some issues the extraction of the tooth. To protect
the vitality of the pulp which is so important for the lifetime, function and
prognose of a tooth, new methods and materials has been improved according to
the increased understanding of the histology and phsyology of the dentin-pulp
complex and the current developments of the adhesive resine systems and
restorative materials. The selective caries removal techniques, disinfection of
the cavity, the pulp capping methods and the currrent treatment methods used in
the presence of a deep dentin caries were discussed in this review.

Key words: Deep Dentine Caries, Disinfection,
Selective Approaches, Stepwise-excavation

Keywords

Aşamalı Çürük Tedavisi, Derin Dentin Çürüğü, Dezenfeksiyon

References

• 1. Mount GJ, Hume WR. A new cavity classification. Aust Dent J 1998;43:153-9.
• 2. Mertz-Fairhurst EJ, Curtis JR JW, Ergle JW, Rueggeberg FA, Adair SM. Ultraconservatıve and carıostatıc sealed restoratıons:results at year 10. JADA 1998;129:55-66.
• 3. Lager A, Thornqvist E, Ericson D. Cultivatable bacteria in dentine after caries excavation using rose-bur or carisolv. Car Res 2003;37:206-11.
• 4. Padmaja M, Raghu R. An ultraconservative method for the treatment of deep carious lesions-step wise excavation. Advan Biol Res 2010;4:42-4.
• 5. Kirzioğlu Z, Gurbuz T, Yilmaz Y. Clinical evaluation of chemomechanical and mechanical caries removal: status of the restorations at 3, 6, 9 and 12 months. Clin Oral Invest 2007;11:69–76.
• 6. Jepsen S, Açil Y, Peschel T, Kargas K, Eberhard J. Biochemical and morphological analysis of dentin following selective caries removal with a fluorescence-controlled er:yag laser. Lasers Surg. Med 2008; 40:350–7.
• 7. Roberson TM, Heymann HO, Switz EJ, Bayne SC, Crawford JJ, Leonard RH ve ark. Sturdevant’s Art and Science of Operative Dentistry. 2006. 6 ed. (Gürgan S , Akça K, Bağış YH, Başeren M, Çakır FY, Çelik EU ve ark. Çev.) Ankara: Güneş Tıp Kitabevleri, 2011.p.101-2
• 8. El-Tekeya M, El-Habashy L, Mokhles N, El-Kimary E. Effectiveness of 2 chemomechanical caries removal methods on residual bacteria in dentin of primary teeth. Pediatr Dent 2012;34:325-30.
• 9. Boston DW. Selective dentin caries excavator. United States Patent 2000;6,106,291. August 22, 2000.
• 10. Boston DW. Partial dentin caries excavator. United States Patent 2002;6,347,941 B1. Feb. 19, 2002.
• 21. Banarjee A, Watson TF, Kidd EAM. Dentine caries excavation: a review of current clinical techniques. Br Dent J 2000;188:476-82.
• 22. Yip HK, Samaranayake LP. Caries removal techniques and instrumentation: a review. Clin Oral İnvest 1998;2:148-54.
• 23. Beltz RE, Herrmann EC, Nordbø H. Pronase digestion of carious dentin.Caries Res 1999;33:468-72.
• 24. Neves AA, Coutinho E, De Munck J, Meerbeek BV. Caries removal effectiveness and minimal-invasiveness potential of caries-excavation techniques: A micro-CT investigation. J Dent 2011;39:154-62.
• 25. Chowdhry S, Saha S, Samadi F, Jaiswal JN, Garg A, Chowdhry P. Recent vs conventional methods of caries removal: a comparative in vivo study in pediatric patients. IJCPD 2015;8:6-11.
• 26. Banarjee A, Kidd EAM, Watson TF. Scanning electron microscopic observations of human dentine after mechanical caries excavation. J Dent 2000;28:179-86.
• 27. Pai VS, Nadig RR, Jagadeesh TG, Usha G, Karthik J, Sridhara KS. Chemical analysis of dentin surfaces after Carisolv treatment. J Consev Dent 2009; 12:118-22.
• 28. Hamama HH, Yiu CKY, Burrow MF, King NM. Chemical, morphological and microhardness changes of dentine after chemomechanical caries removal. Aus Dent J 2013;58:283–92.
• 29. Azrak B, Callaway A, Grundheber A, Stender E, Willershausen B. Comparison of the efficacy of chemomechanical caries removal (Carisolv ) with that of conventional excavation in reducing the cariogenic flora. IAPD 2004;14:182-91.
• 30. Magalhães CS, Moreıra AN, Campos WRC, Rossı FM, Castılho GAA, Ferreıra RC. Effectiveness and efficiency of chemomechanical carious dentin removal. Braz Dent J 2006;17:63-7.
• 41. Maupome G, Hernández-Guerrero JC, García-Luna M, Trejo-Alvarado A, Hernández-Pérez M, Díez-de-Bonilla J. In vivo diagnostic assessment of dentinal caries utilizing acid red and povidone iodine dyes. Oper Dent 1995;20:119-22.
• 42. Kidd EA, Joyston-Bechal S, Beighton D. The use of a caries detector dye during cavity preparation: a microbiological assessment. Br Dent J 1993;174:245-8.
• 43. Arısu HD. Restoratif diş hekimliği ve endodontide lazer kullanımı. GÜ Diş Hek Fak Derg 2009;26: 125-32.
• 44. Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Lasers in dentistry: An innovative tool in modern dental practice. NJMS 2012;3:124-32.
• 45. Walsh LJ. The current status of laser applications in dentistry. Aust Dent J.2003;48:146-55
• 46. Steiner R. New laser technology and future applications. Med Laser Appl 2006;21:131-40.
• 47. Karaaslan EŞ, Yıldırım C, Üşümez A. Restoratif tedavide lazer uygulamaları. Atatürk Üniv Diş Hek Fak Derg 2012;22:340-9.
• 48. Hacıoğulları İ, Ulusoy N, Er F. Dentin aşırı hassasiyeti: tanı ve tedavi yöntemleri. Atatürk Üniv Diş Hek Fak Derg 2015;25: 95-106.
• 49. Sarmadi R, Hedman E, Gabre P. Laser in caries treatment – patients’ experiences and opinions. Int J Dent Hygiene 2014;12:67-73.
• 50. Mehl A, Kremers L, Salzmann K, Hickel R. 3D volume-ablation rate and thermal side effects with the Er: YAG an Nd:YAG laser. Dent Mater 1997;13:246-51.
• 61. Zhang X, Tu R, Yin W, Zhou X, Li X, Hu D. Micro-computerized tomography assessment of fluorescence aided caries excavation (FACE) technology: comparison with three other caries removal techniques. Aus Dent J 2013;58:461-7.
• 62. Lennon ÁM, Buchalla W, Rassner B, Becker K, Attin T. Efficiency of 4 caries excavation methods compared. Oper Dent 2006;31:551-5.
• 63. Lennon ÁM, Attin T, Martens S, Buchalla W. Fluorescence aided caries excavation (FACE), caries detector,and conventional caries exccavation in primary teeth. Pediatr Dent 2009;31:316-9.
• 64. Lennon ÁM, Attin T, Buchalla W. Quantity of remaining bacteria and cavity size after excavation with face, caries detector dye and conventional excavation ın vitro. Oper Dent 2007;32:236-41.
• 65. Lai G, Zhu L, Xu X, Kunzelmann KH. An in vitro comparison of fluorescence-aided caries excavation and conventional excavation by microhardness testing. Clin Oral Invest 2014; 18: 599-605.
• 66. Ganter P, Al-Ahmad A,Wrbas KT, Hellwig E, Altenburger MJ. The use of computer-assisted FACE for minimal-invasive caries excavation. Clin Oral Invest 2014; 18:745-51.
• 67. Dinç G. Kavite dezenfektanlarının antibakteriyel özellikleri, bağlanma dayanımı ve mikrosızıntı üzerine etkileri (derleme). Atatürk Üniv Diş Hek Fak Derg 2012;6:66-75.
• 68. Tüzüner T, Ulusoy AT, Baygin Ö, Yahyaoğlu G, Yalçın İ. Kavite dezenfeksiyonu amacı ile kullanılabilen ticari antibakteriyel jellerin mikrogerilme bağlanma dayanımı üzerine etkinliklerinin değerlendirilmesi. Cumhuriyet Dent J 2012;15:288-96.
• 69. Prabhakar AR, Karuna YM, Yavagal C, Deepak BM. Cavity disinfection in minimally invasive dentistry - comparative evaluation of Aloe vera and propolis: A randomized clinical trial. Contemp Clin Dent 2015; 6:S24-S31.
• 70. Matthijs S, Adriaens PA. Clorhexidine varnishes: a review. J Clin Periodontol 2002;29:1-8
• 81. Parker S. Low-level laser use in dentistry. Br Dent J 2007;202:131-8.
• 82. Siquiera Jr JF, Roças IN. Optimising single-visit disinfection with supplementary approaches: A request for predictability. Aust Endod J 2011;37:92-8.
• 83. Burns T, Wilson M, Pearson GJ. Sensitisation of cariogenic bacteria to killing by light from a helium-neon laser. JMM 1993;38:401-5.
• 84. Wilson M, Dobson J, Harvey W. Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 1992;25:77-81.
• 85. Bergmans L, Moisiadis P, Huybrechts B, Van Meerbeek B, Quirynen M, Lambrechts P. Effect of photo-activated disinfection on endodontic pathogens ex vivo. Int Endod J 2008;41:227-39.
• 86. Bonsor S, Nichol R, Reid TMS, Pearson GJ. Microbiological evaluation of photo-activated disinfection in endodontics (an in vivo study). Br Dent J 2006;200:337-41.
• 87. Williams JA, Pearson GJ, Colles MJ, Wison M. The photo-activated antibacterial action of toluidine blue O in a collagen matrix and in carious dentine. Caries Res 2004;38:530-6.
• 88. Pagonis TC, Chen J, Fontana CR, Devalapally H, Ruggiero K, Song X ve ark. Nano-particle based endodontic antimicrobial photodynamic therapy. J Endod 2010;36:322-38.
• 89. Qureshi A, Soujanya E, Nandakumar, Pratapkumar, Sambashivarao. Recent advances in pulp capping materials: an overview. JCDR 2014;8:316-321.
• 90. Komabayashi T, Zhu Q. Innovative endodontic therapy for anti-inflammatory direct pulp capping of permanent teet with a mature apex. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e75-e81.
• 101. Hesse D, Bonifacio CC, Mendes FM, Braga MM, Imparato JCP, Raggio DP. Sealing versus partial caries removal in primary molars: a randomized clinical trial. BMC Oral Health 2014; 14: 58.
• 102. Innes NPT, Evans DJP. Modern approaches to caries management of the primary dentition. Br Dent J 2013;214:559-566.
• 103. Innes NPT, Evans DJP, Stirrups DR. The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health 2007;7:1-21.
• 104. Innes NPT, Evans DJP, Stirrups DR. Sealing caries in primary molars: randomized control trial, 5 year results. J Dent Res 2011;90:1405–10.
• 105. Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal Intervention Dentistry (MID) for managing dental caries– a review. Int Dent J 2012;62:223-43.
• 106. Santamaria RM, Innes NPT, Machıulskıene V, Evans DJP, Alkılzy M, Splıeth CH. Acceptability of different caries management methods for primary molars in a RC. IAPD 2015;25: 9-17.
• 107. Handelman SL, Leverett DH, Espeland M, Curzon J. Retantion of sealents over carious and sound tooth surfaces. Community Dent Oral Epidemiol 1987;15:1-5.
• 108. Mertz-Fairhurst EJ, Adair SM, Sams DR, Curtis JR JW, Ergle JW, Hawkins KI Mackert JR Jr ve ark. Cariostatic and ultraconservative sealed restorations: nine-year results among children and adults. ASDC J Dent Child 1995;62:97-107.
• 109. Ribeiro CCC, Lula ECO, Costa RCN, Nunes AMM. Rationale for the partial removal of carious tissue in primary teeth. Pediatr Dent 2012;34:39-41.
• 110. Leda L, Azevedo TD, Pimentel PA, de Toledo OA, Bezerra AC. Dentin optical density in molars subjected to partial carious dentin removal. J Clin Pediatr Dent 2015;5:452-7.
• 111. Massara MLA, Bönecker M. Modified ART: Why not?. Braz Oral Res 2012;26:187-9.
• 112. Singhal DP, Acharya S, Thakur AS. Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial. Dent Res J (Isfahan) 2016;13:30-7.
• 113. Maltz M, Henz SL, Oliveira EF, Jardim JJ. Conventional caries removal and sealed caries in permanent teeth: A microbiological evaluation. J Dent 2012;40:776-82.
• 114. Mandari GJ, Truin GJ, van’t Hof MA, Frencken JE. Effectiveness of three minimal intervention approaches for managing dental caries: survival of restorations after 2 years. Caries Res 2001;35:90-4.
• 115. Molina GF, Faulks D, Frencken J. Acceptability, feasibility and perceived satisfaction of the use of the atraumatic restorative treatment approach for people with disability. Braz Oral Res 2015;29:1-9.
• 116. Arrow P, Klobas E. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial. Community Dent Oral Epidemiol 2015;43:511–20.
• 117. Mata C, Allen PF, McKenna G, Cronin M, O’Mahony D, Woods N. Two year survival of ART restorations placed in elderly patient: A randomised controlled clinical trial. J Dent 2015;43:405-11.
• 118. Mata C, Cronin M, O’Mahony D, McKenna G, Woods N, Allen PF. Subjective impact of minimally invasive dentistry in the oral health of older patients. Clin Oral Invest 2015; 19:681-7.
• 119. Banava S, Safaie Yazdi M, Safaie Yazdi M. A 30-month follow-up stepwise excavation without re-entry with three different biomaterials: a case report. JIDA 2013;25:204-9.
• 120. Hayashi M, Fujitani M, Yamaki C, Momoi Y. Ways of enhancing pulp preservation by stepwise excavation- a systematic review. J Dent 2011;39:95-107.
• 131. Hevinga MA, Opdam NJ, Frencken JE, Truin GJ, Huysmans MCDNJM. Does incomplete caries removal reduce strength of restored teeth? J Dent Res 2010;89:1270-5.
• 132. Ricketts D, Lamont T, Innes NPT, Kidd E, Clarkson JE. Operative caries management in adults and children (Review). CDSR 2013;3:1-52.
• 133. Bjorndal L, Thylstrup A. A practise-based study on stepwise excavation of deep carious lesions in permanent teeth: A 1-year follow-up study. Community Dent Oral Epidemiol 1998;26:122-8.
• 134. Doi J, Itota T, Torii Y, Nakabo S, Yoshiyama M. Micro-tensile bond strength of self-etching primer adhesive systems to human coronal carious dentin. J Oral Rehabil 2004;31:1023-8.
• 135. Doi J, Itota T, Yoshiyama M, Tay FR, Pashley DH. Bonding to root caries by a self-etching adhesive system containing MDPB. Am J Dent 2004;17:89-93.
• 136. Kimochi T, Yoshiyama M, Urayama A. Adhesion of a new commercial self-etching/ self-priming bonding resin to human caries-infected dentin. Dent Mater J 1999;18:437-43.
• 137. Yoshiyama M, Tay FR, Doi J, Nishitani Y, Yamada T, Itou K ve ark. Bonding of self-etch and total-etch adhesives to carious dentin. J Dent Res 2002;81:556-60.
• 138. Yoshiyama M, Tay FR, Torii Y, Nishitani Y, Doi J, Itou K ve ark. Resin adhesion to carious dentin. Am J Den 2003;16:47-52.
• 139. Yoshiyama M, Doi J, Nishitani Y, Itota T, Tay FR, Carvalho RM ve ark. Bonding ability of adhesive resins to caries-affected and caries-infected dentin. J Appl Oral Sci 2004;12:171-176