TRAVMAYA BAĞLI VİTALİTESİNİ KAYBETMİŞ VE RENK DEĞİŞİKLİĞİNE UĞRAMIŞ ÜST SANTRAL DİŞİN REHABİLİTASYONU

Yıl 2019, Cilt: 46 Sayı: 2, 109 - 114, 01.08.2019

Ahmet Orhun Karacan Perihan Özyurt

Öz

30 yaşındaki kadın hasta 21 numaralı dişindeki internal renklenme şikayeti ile kliniğimize başvurmuştur. Klinik muayenede 21 numaralı dişin bukkalinde bir fistül olduğu ve dişte mobilite olduğu görülmüştür. Alınan detaylı anamnezde çocukluk yıllarında o bölgeye travma hikayesine rastlanmıştır. Radyografik muayenede dişin apikalinde büyük bir lezyon ve kökte rezorbsiyon olduğu görülmüştür. Hastaya tedavi öncesi riskler anlatılmış ve kök kanal tedavisine başlanmıştır. İlk seansta giriş kavitesi açılmış, kanal boyu tespiti yapılmıştır. K-tipi eğelerle kanal içi debrisleri temizlemek için preparasyon yapılmış, irrigasyon solüsyonu olarak sodyum hipoklorit kullanılmıştır. Kanal içine kalsiyum hidroksit gönderilmiş ve geçici dolgu materyali ile kavite kapatılmış 1 hafta sonraya hastaya randevu verilmiştir. İkinci seans ve üçüncü seansta h-tipi el eğeleri preparasyon yapılmış ve sodyum hipoklorit ile irrigasyon yapılmıştır ve kanala kalsiyum hidroksit gönderilerek pansumana devam edilmiştir. Son seansta preparasyon tamamlanıp lateral kondensasyon tekniği ile doldurulmuştur. 1.hafta sonunda dişin bukkalindeki fistül yolu kapanmış 2. Haftada dişteki mobilite sıfırlanmıştır. Kök kanal tedavisi sonrası cam iyonomer bir bariyer oluşturulup de-vital (Opalesance Endo %35,Almanya) beyazlatma yapılmıştır. 1 aylık kontrol filminde apikal lezyonun iyileştiği görülmüş ve estetik açıdan hastanın beklentisi karşılanmıştır.

Anahtar Kelimeler

beyazlatma, kök kanalı, travma

Rehabilitation of upper central tooth lost and discolored due to trauma

Öz

A 30-year-old female patient was admitted to our clinic with the complaint of internal coloration in her tooth 21. In clinical examination, tooth 21 was found to have a fistula in the buccal cervix and mobility in the tooth. The detailed history revealed a history of trauma to the region in childhood. On the radiographic examination, a large lesion of the tooth and resorption of the root were observed. Pre-treatment risks were explained to the patient and root canal treatment was started. Entrance cavity was opened in the first session, channel length was determined. K-type files were used to remove debris and sodium hypochlorite was used as irrigation solution. Calcium hydroxide was introduced into the canal and cavity was closed with temporary filling material and the patient was given an appointment after 1 week. In the second session and third session, h-type hand files were prepared and irrigated with sodium hypochlorite and calcium hydroxide was sent to the root canal and the dressing continued. In the last session, the preparation was completed and filled with lateral condensation technique. At the end of the first week, the fistula in the buccal of the tooth was closed. After root canal treatment, glass ionomer formed a barrier and bleached de-vital (Opalesance Endo 35%, Germany). The apical lesion was recovered in the 1-month control film and the patient's expectations were met in terms of aesthetics.

Anahtar Kelimeler

bleaching, root canal, trauma

Kaynakça

• Dudea D, Lasserre JF, Alb C, Culic B, Pop Ciutrila IS, Colosi H. Patients' perspective on dental aesthetics in a south-eastern European community. J Dent 2012; 40:72–81.
• Martin J, Rivas V, Vildosola P, Moncada L, Oliveira Junior OB, Saad JR, Fernandez E, Moncada G. Personality style in patients looking for tooth bleaching and its correlation with treatment satisfaction. Braz Dent J 2016; 27:60-5.
• Çalışkan K. Endodontide Tanı ve Tedaviler. İzmir, Nobel Tıp Kitabevleri Ltd. Şti. 2009: sf 57
• Attin T, Paqué F, Ajam F, Lennon AM. Review of the current status of tooth whitening with the walking bleach technique. Int Endod J 2003; 36(5):313- 29
• Plotino G, Buono L, Grande NM, Pameijer CH, Somma F. Nonvital tooth bleaching: a review of the literature and clinical procedures. J Endod 2008;34:394–407.
• Fasanaro TS. Bleaching teeth: history, chemicals, and methods used for common tooth discolorations. J Esthet Dent 1992; 4(3): 71-8
• Cvek M, Lindvall AM. External root resorption following bleaching of pulpless teeth with oxy- gen peroxide. Endod Dent Traumatol 1985;1(2):56-60.
• Attin T, Paque F, Ajam F, Lennon AM. Review of the current status of tooth whitening with the walking bleach technique. Int Endod J 2003;36(5):313-29.
• Friedman S, Rotstein I, Libfeld H, Stabholz A, Heling I. Incidence of external root resorption and esthetic results in 58 bleached pulpless teeth. Endod Dent Traumatol 1988; 4(1): 23-6.
• Nutting EB, Poe GS. Chemical bleaching of discolored endodontically treated teeth. Dent Clin North Am 1967;655-62.
• de Oliveira LD, Carvalho CA, Hilgert E, Bondioli IR, de Araújo MA, Valera MC. Sealing evaluation of the cervical base in intracoronal bleaching. Dent Traumatol 2003;19(6):309-13.
• Lim MY, Lum SO, Poh RS, Lee GP, Lim KC. An in vitro comparison of the bleaching efficacy of 35% carbamide peroxide with established intracoronal bleaching agents. Int Endod J 2004;37(7):483-8.
• Vachon C, Vanek P, Friedman S. Internal bleaching with 10% carbamide peroxide in vitro. Pract Periodontics. Aesthet Dent 1998;10(9):1145-52.
• Nathoo SA. The chemistry and mechanisms of extrinsic and intrinsic discoloration. J Am Dent Assoc 1997;128:6-10.
• Zimmerli B, Jeger F, Lussi A. Bleaching of nonvital teeth. A clinically relevant literature review. Schweiz Monatsschr Zahnmed 2010;120(4):306-20.
• Farmer DS, Burcham P, Marin PD. The ability of thiourea to scavenge hydrogen peroxide and hydroxyl radicals during the intracoronal bleaching of bloodstained root-filled teeth. Aust Dent J 2006;51(2): 146-52.
• Dietschi D, Rossier S, Krejci I. In vitro colorimetric evaluation of the efficacy of various bleaching methods and products. Quintessence Int 2006;37(7):515-26.
• Casey LJ, Schindler WG, Murata SM, Burgess JO. The use of dentinal etching with en- dodontic bleaching procedures. J Endod 1989;15(11):535-8.