Kavite temizleyicleri ve restorasyon protokollerinin endodontik tedavi görmüş dişlerdeki mikrosızıntı üzerine etkisi

Abstract

Amaç: Farklı kavite temizleyicileri ve irrigasyon solüsyonlarının kullanımı, restorasyonların uzun dönem başarısını ve kanal tedavilerinin koronal sızdırmazlığını etkileyebilir. Bu çalışmanın amacı, kavite temizleyicileri ve restorasyon protokollerinin, endodontik tedavi görmüş dişlerde rezin modifiye cam iyonomer siman (RMGIC) restorasyonlarının mikrosızıntısı üzerindeki etkilerini incelemektir. Gereç ve Yöntem: Bu çalışmads seksen adet çürüksüz, maksiller birinci molar diş kullanılmıştır. Standart 4×4 mm giriş kaviteleri hazırlanmış, kök kanalları enstrümante edilip lateral kondensasyon tekniği ile doldurulmuştur. Dişler yüzey temizleyici protokolüne göre sekiz gruba ayrılmıştır: temizleyici uygulanmayan, Cavity Conditioner, Dentin Conditioner ve Triton uygulanan gruplar; daha sonra gruplar, adezivuygulanan ve uygulanmayan olarak ayrılıp ve RMGIC ile restore edilmiştir. Örnekler yaşlandırıldıktan sonra, %0.5 bazik fuksin içinde bekletilmiştir. Boya penetrasyonu, stereomikroskop (×40) altında 0-3 arası skorlamayla değerlendirilmiştir. Veriler, temizleyici ve adeziv faktörleri sabit değişken olarak alınarak oransal-olasılık ordinal lojistik regresyon ile analiz edilmiştir. Etki büyüklükleri olasılık oranı (95% GA) olarak ifade edilmiştir. Grup karşılaştırmaları Kruskal–Wallis testi (Holm düzeltmeli, α = 0.05) ile yapılmış ve analizler R Studio (v2025.09.1+401) programında yürütülmüştür. Bulgular: Gruplar arasında mikrosızıntı değerleri anlamlı fark göstermiştir (p < 0.05). Adeziv kullanımı mikrosızıntıyı belirgin şekilde azaltırken (χ² = 46.69; p < 0.05), ön işlem de güçlü bir etki göstermiştir (LR χ² = 70.47; p < 0.05). Post-hoc analiz, TR+Bond+RMGIC grubunun DC+Bond+RMGIC ve CC+Bond+RMGIC gruplarına kıyasla anlamlı derecede daha az sızdırmazlık sağladığını göstermiştir (p < 0.01). Sonuç: Endodontik tedavi görmüş dişlerde RMGIC restorasyon öncesinde adeziv ve uygun yüzey temizleyici protokollerinin uygulanması önerilmektedir.

Keywords

• Kavite Arıtıcı
• Konservatif Tedavi
• Dental Materyaller
• Endodonti

Coronal cavity pretreatment agents and restoration protocols effect on microleakage of endodontically treated teeth

Abstract

Aims: The use of various cavity disinfectants and irrigants can influence the long-term success of restorations, thereby affecting the seal integrity of root canal treatments. This study aimed to investigate the effects of cavity cleansers and bonding protocols on the microleakage of resin-modified glass ionomer cement (RMGIC) restorations in endodontically treated teeth. Methods: Eighty extracted, non-carious maxillary first molars were used. Standardized 4×4 mm access cavities were prepared, and root canals were instrumented and obturated using the lateral condensation technique. The teeth were divided into eight groups according to the surface pretreatment protocol: no pretreatment, Cavity Conditioner, Dentin Conditioner, and Triton application, and then restored with RMGIC with and without an adhesive. After thermocycling, specimens were immersed in 0.5% basic fuchsin. Dye penetration was evaluated under a stereomicroscope (×40) using a 0–3 scoring system. Data were analyzed using ordinal logistic regression with pretreatment and bonding as fixed factors. Effect sizes were expressed as odds ratios (95% CI). Group comparisons were performed with the Kruskal–Wallis test (Holm-adjusted, α=0.05) using RStudio (v2025.09.1+401). Results: Microleakage scores varied significantly among groups (p<0.05). Use of adhesive markedly reduced microleakage (χ²=46.69; p<0.05), while pretreatment type exerted a strong effect (LR χ²=70.47; p<0.05). Post-hoc analysis revealed significantly greater microleakage with TR+Bond+RMGIC than with DC+Bond+RMGIC or CC+Bond+RMGIC (p<0.01). Conclusion: Applying adhesive and pretreatment protocols before RMGIC restoration, especially in endodontically treated teeth, is advisable.

Keywords

• Cavity conditioner
• conservative treatment
• dental materials
• endodontics

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