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

Year 2026, Volume: 7 Issue: 1, 40 - 45, 20.02.2026
https://izlik.org/JA84UK79XZ

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.

Ethical Statement

Etik onay, Ankara Medipol Üniversitesi Etik Kurulu’ndan alınmıştır (Onay No: E-85859696-604.01.01-10709).

Supporting Institution

belirtilmemiş

Thanks

Belirtilmemiş

References

  • Özcan M, Volpato CAM. Current perspectives on dental adhesion: (3) adhesion to intraradicular dentin: concepts and applications. Jpn Dent Sci Rev. 2020;56(1):216-223. doi:10.1016/j.jdsr.2020.06.001
  • Saikaew P, Sattabanasuk V, Harnirattisai C, Chowdhury A, Carvalho R, Sano H. Role of the smear layer in adhesive dentistry and the clinical applications to improve bonding performance. Jpn Dent Sci Rev. 2022; 58:59-66. doi:10.1016/j.jdsr.2021.12.001
  • Alshaikh KH, Hamama HHH, Mahmoud SH. Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis. Restor Dent Endod. 2018;43(2):e14. doi:10.5395/rde.2018.43.e14
  • Samy FM, El-Kholany NR, Hamama HHH. Evaluation of bond durability of different self-adhesive bioactive restorative systems to dentin. Sci Rep. 2025;15(1):3667. doi:10.1038/s41598-024-81351-9
  • Scholz KJ, Sim W, Bopp S, et al. Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro. Int Endod J. 2022;55(9):950-963. doi:10.1111/iej.13773
  • Devroey S, Calberson F, Meire M. The efficacy of different cleaning protocols for the sealer-contaminated access cavity. Clin Oral Investig. 2020;24(11):4101-4107. doi:10.1007/s00784-020-03385-9
  • Mazaheri R, Pishevar L, Shichani AV, Geravandi S. Effect of different cavity conditioners on microleakage of glass ionomer cement with a high viscosity in primary teeth. Dent Res J (Isfahan). 2015;12(4):337-341. doi:10.4103/1735-3327.161461
  • de Melo Avila W, Hesse D, Bonifacio CC. Surface conditioning prior to the application of glass-ionomer cement: a systematic review and meta-analysis. J Adhes Dent. 2019;21(5):391-399. doi:10.3290/j.jad.a43239
  • Hajaj T, Perdiou A, Sinescu C, et al. Evaluation of different coronal sealing materials in the endodontically treated teeth: an in vitro study. Adv Mater Sci Eng. 2021;2021(1):9977951. doi:10.1155/2021/9977951
  • Chen P, Chen Z, Teoh YY, Peters OA, Peters CI. Orifice barriers to prevent coronal microleakage after root canal treatment: systematic review and meta-analysis. Aust Dent J. 2022;67(2):78-91. doi:10.1111/adj.12915
  • Abdelsamie EA, Abdalla AI, Salama MM. The effect of flowable composite and glass ionomer liner on the marginal integrity of class II composite resin restorations. Tanta Dent J. 2024;21(2):208-215. doi:10. 4103/tdj.tdj_12_24
  • Çelik EU, Yapar AGD, Ateş M, Şen BH. Bacterial microleakage of barrier materials in obturated root canals. J Endod. 2006;32(11):1074-1076. doi:10.1016/j.joen.2006.07.012
  • Tselnik M, Baumgartner JC, Marshall JG. Bacterial leakage with mineral trioxide aggregate or a resin-modified glass ionomer used as a coronal barrier. J Endod. 2004;30(11):782-784. doi:10.1097/01.don.0000128740. 53154.7c
  • Abdullah M, Aljubori S. Evaluation of the effect of different intraorifice barrier materials on coronal microleakage of endodontically treated teeth by using micro-computed tomography technology (a comparative in vitro study). Georgian Med News. 2023;(340-341):122-130.
  • Ogliari FA, Piva E, Demarco FF, de Araújo CS, da Silva TI, Meireles SS. Microleakage of seven adhesive systems in enamel and dentin. J Contemp Dent Pract. 2008;7:26-33.
  • Sidhu SK, Nicholson JW. A review of glass-ionomer cements for clinical dentistry. J Funct Biomater. 2016;7(3):16. doi:10.3390/jfb7030016
  • Poggio C, Beltrami R, Scribante A, Colombo M, Lombardini M. Effects of dentin surface treatments on shear bond strength of glass-ionomer cements. Ann Stomatol (Roma). 2014;5(1):15.
  • Mount G, Hume W. Preservation and restoration of tooth structure. Br Dent J. 2000;188(3):170. doi:10.1038/sj.bdj.4800436a
  • Nicholson JW. Chemistry of glass-ionomer cements: a review. Biomaterials. 1998;19(6):485-494. doi:10.1016/S0142-9612(97)00128-2
  • Es-Souni M, Fischer-Brandies H, Zaporojshenko V, Es-Souni M. On the interaction of polyacrylic acid as a conditioning agent with bovine enamel. Biomaterials. 2002;23(14):2871-2878. doi:10.1016/S0142-9612 (01)00407-1
  • Gürler S, Demirel A, Buyuksungur A. The evaluation of internal adaptation of glass ionomer restorations applied after the use of different cavity conditioners in primary teeth: an in-vitro study. BMC Oral Health. 2025;25(1):36. doi:10.1186/s12903-025-04981-7
  • Ugurlu M. Bonding of a resin-modified glass ionomer cement to dentin using universal adhesives. Restor Dent Endod. 2020;45(3):e30. doi:10. 5395/rde.2020.45.e30
  • Pameijer CH. A review of luting agents. Int J Dent. 2012;2012:752861. doi:10.1155/2012/752861
  • Klaisiri A, Phumpatrakom P, Thamrongananskul N. Chemical surface modification methods of resin composite repaired with resin-modified glass-ionomer cement. Eur J Dent. 2023;17(3):804-808. doi:10.1055/s- 0043-1771355
  • Hardan L, Bourgi R, Kharouf N, et al. Bond strength of universal adhesives to dentin: a systematic review and meta-analysis. Polymers (Basel). 2021;13(5):814. doi:10.3390/polym13050814
  • Jafarnia S, Meymand JZ, Zandkarimi F, et al. Comparative evaluation of microtensile bond strength of three adhesive systems. Front Dent. 2022; 19:8. doi:10.18502/fid.v19i8.10848
  • Bayrak S, Sen Tunc E, Tuloglu N. The effects of surface pretreatment on the microleakage of resin-modified glass-ionomer cement restorations. J Clin Pediatr Dent. 2012;36(3):279-284. doi:10.17796/jcpd.36.3.3u2q 0j4 j7k8k1k82
  • Sadeghi M, Atafat M, Abbasi M. Shear bond strength evaluation of resin composite to resin-modified glass-ionomer cement using three different resin adhesives vs. glass-ionomer based adhesive. J Dent Mater Tech. 2015;4(4):153-160.
  • Perdigão J. Current perspectives on dental adhesion: (1) dentin adhesion–not there yet. Jpn Dent Sci Rev. 2020;56(1):190-207. doi:10. 1016/j.jdsr.2020.06.002
  • Oraim HW, Al-Zaka IM. Effectiveness of triton irrigation solution in smear layer removal: an in-vitro study. Eur Endod J. 2024;9(2):139. doi: 10.14744/eej.2024.139
  • Sekhar A, Anil A, Thomas MS, Ginjupalli K. Effect of various dentin disinfection protocols on the bond strength of resin modified glass ionomer restorative material. J Clin Exp Dent. 2017;9(7):e837-e842. doi: 10.4317/jced.53745
  • Gupta A, Tavane P, Gupta PK, et al. Evaluation of microleakage with total etch, self etch and universal adhesive systems in class V restorations: an in vitro study. J Clin Diagn Res. 2017;11(4):ZC53-ZC57. doi:10.7860/JCDR/2017/25809.9727
  • Sooraparaju SG, Kanumuru PK, Nujella SK, Konda KR, Reddy KBK, Penigalapati S. A comparative evaluation of microleakage in class V composite restorations. Int J Dent. 2014;2014:685643. doi:10.1155/2014/ 685643

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

Year 2026, Volume: 7 Issue: 1, 40 - 45, 20.02.2026
https://izlik.org/JA84UK79XZ

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.

Ethical Statement

Ethical approval was obtained from the Ankara Medipol University Ethics Committee (Approval No: E-85859696-604.01.01-10709).

Supporting Institution

none

Thanks

None

References

  • Özcan M, Volpato CAM. Current perspectives on dental adhesion: (3) adhesion to intraradicular dentin: concepts and applications. Jpn Dent Sci Rev. 2020;56(1):216-223. doi:10.1016/j.jdsr.2020.06.001
  • Saikaew P, Sattabanasuk V, Harnirattisai C, Chowdhury A, Carvalho R, Sano H. Role of the smear layer in adhesive dentistry and the clinical applications to improve bonding performance. Jpn Dent Sci Rev. 2022; 58:59-66. doi:10.1016/j.jdsr.2021.12.001
  • Alshaikh KH, Hamama HHH, Mahmoud SH. Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis. Restor Dent Endod. 2018;43(2):e14. doi:10.5395/rde.2018.43.e14
  • Samy FM, El-Kholany NR, Hamama HHH. Evaluation of bond durability of different self-adhesive bioactive restorative systems to dentin. Sci Rep. 2025;15(1):3667. doi:10.1038/s41598-024-81351-9
  • Scholz KJ, Sim W, Bopp S, et al. Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro. Int Endod J. 2022;55(9):950-963. doi:10.1111/iej.13773
  • Devroey S, Calberson F, Meire M. The efficacy of different cleaning protocols for the sealer-contaminated access cavity. Clin Oral Investig. 2020;24(11):4101-4107. doi:10.1007/s00784-020-03385-9
  • Mazaheri R, Pishevar L, Shichani AV, Geravandi S. Effect of different cavity conditioners on microleakage of glass ionomer cement with a high viscosity in primary teeth. Dent Res J (Isfahan). 2015;12(4):337-341. doi:10.4103/1735-3327.161461
  • de Melo Avila W, Hesse D, Bonifacio CC. Surface conditioning prior to the application of glass-ionomer cement: a systematic review and meta-analysis. J Adhes Dent. 2019;21(5):391-399. doi:10.3290/j.jad.a43239
  • Hajaj T, Perdiou A, Sinescu C, et al. Evaluation of different coronal sealing materials in the endodontically treated teeth: an in vitro study. Adv Mater Sci Eng. 2021;2021(1):9977951. doi:10.1155/2021/9977951
  • Chen P, Chen Z, Teoh YY, Peters OA, Peters CI. Orifice barriers to prevent coronal microleakage after root canal treatment: systematic review and meta-analysis. Aust Dent J. 2022;67(2):78-91. doi:10.1111/adj.12915
  • Abdelsamie EA, Abdalla AI, Salama MM. The effect of flowable composite and glass ionomer liner on the marginal integrity of class II composite resin restorations. Tanta Dent J. 2024;21(2):208-215. doi:10. 4103/tdj.tdj_12_24
  • Çelik EU, Yapar AGD, Ateş M, Şen BH. Bacterial microleakage of barrier materials in obturated root canals. J Endod. 2006;32(11):1074-1076. doi:10.1016/j.joen.2006.07.012
  • Tselnik M, Baumgartner JC, Marshall JG. Bacterial leakage with mineral trioxide aggregate or a resin-modified glass ionomer used as a coronal barrier. J Endod. 2004;30(11):782-784. doi:10.1097/01.don.0000128740. 53154.7c
  • Abdullah M, Aljubori S. Evaluation of the effect of different intraorifice barrier materials on coronal microleakage of endodontically treated teeth by using micro-computed tomography technology (a comparative in vitro study). Georgian Med News. 2023;(340-341):122-130.
  • Ogliari FA, Piva E, Demarco FF, de Araújo CS, da Silva TI, Meireles SS. Microleakage of seven adhesive systems in enamel and dentin. J Contemp Dent Pract. 2008;7:26-33.
  • Sidhu SK, Nicholson JW. A review of glass-ionomer cements for clinical dentistry. J Funct Biomater. 2016;7(3):16. doi:10.3390/jfb7030016
  • Poggio C, Beltrami R, Scribante A, Colombo M, Lombardini M. Effects of dentin surface treatments on shear bond strength of glass-ionomer cements. Ann Stomatol (Roma). 2014;5(1):15.
  • Mount G, Hume W. Preservation and restoration of tooth structure. Br Dent J. 2000;188(3):170. doi:10.1038/sj.bdj.4800436a
  • Nicholson JW. Chemistry of glass-ionomer cements: a review. Biomaterials. 1998;19(6):485-494. doi:10.1016/S0142-9612(97)00128-2
  • Es-Souni M, Fischer-Brandies H, Zaporojshenko V, Es-Souni M. On the interaction of polyacrylic acid as a conditioning agent with bovine enamel. Biomaterials. 2002;23(14):2871-2878. doi:10.1016/S0142-9612 (01)00407-1
  • Gürler S, Demirel A, Buyuksungur A. The evaluation of internal adaptation of glass ionomer restorations applied after the use of different cavity conditioners in primary teeth: an in-vitro study. BMC Oral Health. 2025;25(1):36. doi:10.1186/s12903-025-04981-7
  • Ugurlu M. Bonding of a resin-modified glass ionomer cement to dentin using universal adhesives. Restor Dent Endod. 2020;45(3):e30. doi:10. 5395/rde.2020.45.e30
  • Pameijer CH. A review of luting agents. Int J Dent. 2012;2012:752861. doi:10.1155/2012/752861
  • Klaisiri A, Phumpatrakom P, Thamrongananskul N. Chemical surface modification methods of resin composite repaired with resin-modified glass-ionomer cement. Eur J Dent. 2023;17(3):804-808. doi:10.1055/s- 0043-1771355
  • Hardan L, Bourgi R, Kharouf N, et al. Bond strength of universal adhesives to dentin: a systematic review and meta-analysis. Polymers (Basel). 2021;13(5):814. doi:10.3390/polym13050814
  • Jafarnia S, Meymand JZ, Zandkarimi F, et al. Comparative evaluation of microtensile bond strength of three adhesive systems. Front Dent. 2022; 19:8. doi:10.18502/fid.v19i8.10848
  • Bayrak S, Sen Tunc E, Tuloglu N. The effects of surface pretreatment on the microleakage of resin-modified glass-ionomer cement restorations. J Clin Pediatr Dent. 2012;36(3):279-284. doi:10.17796/jcpd.36.3.3u2q 0j4 j7k8k1k82
  • Sadeghi M, Atafat M, Abbasi M. Shear bond strength evaluation of resin composite to resin-modified glass-ionomer cement using three different resin adhesives vs. glass-ionomer based adhesive. J Dent Mater Tech. 2015;4(4):153-160.
  • Perdigão J. Current perspectives on dental adhesion: (1) dentin adhesion–not there yet. Jpn Dent Sci Rev. 2020;56(1):190-207. doi:10. 1016/j.jdsr.2020.06.002
  • Oraim HW, Al-Zaka IM. Effectiveness of triton irrigation solution in smear layer removal: an in-vitro study. Eur Endod J. 2024;9(2):139. doi: 10.14744/eej.2024.139
  • Sekhar A, Anil A, Thomas MS, Ginjupalli K. Effect of various dentin disinfection protocols on the bond strength of resin modified glass ionomer restorative material. J Clin Exp Dent. 2017;9(7):e837-e842. doi: 10.4317/jced.53745
  • Gupta A, Tavane P, Gupta PK, et al. Evaluation of microleakage with total etch, self etch and universal adhesive systems in class V restorations: an in vitro study. J Clin Diagn Res. 2017;11(4):ZC53-ZC57. doi:10.7860/JCDR/2017/25809.9727
  • Sooraparaju SG, Kanumuru PK, Nujella SK, Konda KR, Reddy KBK, Penigalapati S. A comparative evaluation of microleakage in class V composite restorations. Int J Dent. 2014;2014:685643. doi:10.1155/2014/ 685643
There are 33 citations in total.

Details

Primary Language English
Subjects Endodontics, Restorative Dentistry, Dental Materials
Journal Section Research Article
Authors

Lena Bal 0000-0003-3493-0137

Cangül Keskin 0000-0001-8990-4847

Aybüke Karaca Sakallı 0000-0001-5472-0781

Osman Fatih Aydın 0009-0009-4115-6021

Submission Date November 12, 2025
Acceptance Date January 22, 2026
Publication Date February 20, 2026
IZ https://izlik.org/JA84UK79XZ
Published in Issue Year 2026 Volume: 7 Issue: 1

Cite

AMA 1.Bal L, Keskin C, Karaca Sakallı A, Aydın OF. Coronal cavity pretreatment agents and restoration protocols effect on microleakage of endodontically treated teeth. J Med Palliat Care / JOMPAC / jompac. 2026;7(1):40-45. https://izlik.org/JA84UK79XZ

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