Endodonti-Ortodonti Arayüzü: Endodontik Tedavi, Ortodontik Kuvvet ve Dental Pulpa İlişkisi

Year 2022, Volume: 8 Issue: 1, 16 - 23, 21.11.2022

Büşra Demir Çiçek , Orhan Çiçek

Abstract

Modern endodontik ve ortodontik tedavilerdeki klinik karar verme süreçlerinde her iki uzmanlık alanında da bilimsel kanıtlara dayalı bilgilere ihtiyaç duyulmaktadır. Endodontik tedavili dişlere uygulanan ortodontik diş hareketi, uzun yıllardır klinisyenler tarafından ikilem ve karışıklıklarla ele alımıştır. Ortodontik kuvvet, diş pulpasının biyolojik tepkisini uyandırır ve endodontik tedavili bir dişe uygulanan bu kuvvet, periodontal ligament ve pulpa dokusunda geri dönüşümsüz biyolojik reaksiyonları tetikleyebilir. Hafif ve sürekli veya aralıklı kuvvetlerle istenilen düzeyde diş hareketi elde edilebilir ve böylece pulpal hasar sınırlanarak hasarlı pulpanın da iyileşmesi sağlanır. Endodontik tedavili dişlerin ortodontik hareketi, diş ve çevre dokuların dikkatlice değerlendirilmesini gerektirip endodontik tedavinin kalitesinden, periapikal lezyonlardan ve önceki travma öyküsünden etkilenir. Bununla birlikte, ağır ve uzun süreli ortodontik kuvvetler pulpa nekrozuna, geri dönüşü olmayan pulpitise ve eksternal kök rezorpsiyonuna neden olur. Ayrıca, endodontik tedavili bir dişte ortodontik tedaviyi takiben gelişen kök rezorpsiyonlarının yönetimi zor olabilir. Bu derlemede, ortodontik kuvvetin sağlıklı dental pulpaya ve endodontik tedavili dişlerin pulpasına etkileri hakkında önemli bilgilerin güncel bilimsel kanıtlar gözden geçirilerek açıklığa kavuşturulması amaçlanmıştır.

Keywords

endodontik tedavi, ortodontik diş hareketi, ortodontik kuvvet, pulpa

Endodontic-Orthodontic Interface: Endodontic Treatment, Orthodontic Force and Dental Pulp Relationship

Abstract

Scientific evidence-based data is needed in both areas of speciality in clinical decision-making processes in modern endodontics and orthodontics. Orthodontic tooth movement applied to endodontically treated teeth has been handled with dilemmas and confusion by clinicians for many years. Orthodontic force evokes the biological response of the pulp, and this force applied to an endodontically treated tooth can stimulate irreversible reactions in the periodontal ligament and pulp tissue. With light and continuous or intermittent forces, desired level of orthodontic tooth movement can be achieved, thus limiting pulpal damage and healing of damaged pulp. Orthodontic movement of endodontically treated teeth requires carefully evaluation of teeth and surrounding tissues and is affected by the quality of endodontic treatment, periapical lesions, and previous trauma history. However, severe and prolonged orthodontic forces cause pulp necrosis, irreversible pulpitis and external root resorption. Root resorption following orthodontic treatment in an endodontically treated tooth can be difficult to manage. In this review, it is aimed to clarify important information about the effects of orthodontic force on healthy dental pulp and the pulp of endodontically treated teeth, by reviewing current scientific evidence.

Keywords

Endodontic treatment, orthodontic tooth movement, orthodontic force, pulp

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