Farklı İrrigasyon Aktivasyon Tekniklerinin Kalsiyum Hidroksit Uzaklaştırmadaki Etkinliğinin Taramalı Elektron Mikroskobu ile İncelenmesi

Year 2023, Volume: 5 Issue: 2, 60 - 66, 28.08.2023

Okan Uysal , Betül Aycan Uysal , Hesna Sazak Öveçoğlu

Abstract

Amaç: Bu çalışma, kök kanallarından kalsiyum hidroksitin uzaklaştırılması sırasında farklı irrigasyon aktivasyon tekniklerinin etkinliğini karşılaştırmayı amaçlamıştır. Gereç ve Yöntemler: Toplam 75 adet çekilmiş tek köklü diş şekillendirildikten sonra kök kanalları kalsiyum hidroksit ile doldurulmuştur. Örnekler kalsiyum hidroksitin uzaklaştırılması sırasında kullanılan irrigasyon aktivasyon yöntemlerine göre rastgele beş gruba (n = 15) ayrılmıştır: manuel irrigasyon, EndoActivator, pasif ultrasonik irrigasyon, EDDY ve XPendo Finisher. Her numune longitudinal olarak 2 parçaya ayrılmıştır ve 500X büyütmeli bir taramalı elektron mikroskobu kullanılarak görüntülenmiştir. Elde edilen veriler ki-kare testi kullanılarak karşılaştırılmıştır (p < 0.05). Bulgular: Orta üçlüde kalsiyum hidroksitin uzaklaştırılmasında EDDY en etkili yöntem olarak bulunmuştur (p = 0.025). Koronal (p = 0.327) ve apikal üçlüde (p = 0.071) kalsiyum hidroksitin uzaklaştırılmasında test edilen irrigasyon aktivasyon yöntemleri arasında istatistiksel olarak anlamlı bir fark bulunamamıştır. Sonuç: Hiçbir irrigasyon aktivasyon tekniği kalsiyum hidroksiti kanal duvarlarından tamamen uzaklaştırmamasına rağmen, manuel irrigasyon diğer tüm aktivasyon tekniklerinden daha az etkili bulunmuştur. Sonik ve ultrasonik aktivasyon sistemleri, daha fazla kalsiyum hidroksitin uzaklaştırılmasına olanak sağlamıştır.

Keywords

Kalsiyum hidroksit, pasif ultrasonik irrigasyon, sonik aktivasyon tekniği

Supporting Institution

Marmara Üniversitesi Bilimsel Araştırma Projeleri Komisyonu

Project Number

SAG-C-DUP-110618-0297

Thanks

-

Effectiveness of Different Irrigation Activation Techniques in Removing Calcium Hydroxide Assessed with Scanning Electron Microscopy

Abstract

Aim: This study aimed to compare the effectiveness of different irrigation activation techniques during the removal of calcium hydroxide
paste from the root canals.
Material and Methods: Seventy-five extracted single-rooted teeth were shaped and filled with calcium hydroxide paste. The samples
were randomly divided into five groups (n = 15) according to the irrigation activation methods used: manual irrigation, EndoActivator,
passive ultrasonic irrigation, EDDY, and XPendo Finisher. Each sample was split longitudinally and imaged using a scanning electron
microscope with 500X magnification. Data were compared using the chi-squared test (p < 0.05).
Results: A statistically significant difference was found at the middle third, with EDDY being the most effective in removing calcium hydroxide
(p = 0.025). The differences between the tested irrigation activation methods in removing calcium hydroxide from the coronal
third (p = 0.327) and apical third (p = 0.071) were not statistically significant.
Conclusion: Although none of the irrigation activation techniques completely removed calcium hydroxide from the canal walls, manual
irrigation was less effective than all the other activation techniques. The sonic and ultrasonic activation systems allowed more calcium
hydroxide paste to be removed.

Keywords

Calcium hydroxide, passive ultrasonic irrigation

Project Number

SAG-C-DUP-110618-0297

References

• 1. Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2005;99:231-52.
• 2. Athanassiadis BA, George GA, Abbott P V., Wash LJ. A review of the effects of formaldehyde release from endodontic materials. Int Endod J. 2015;48:829-38.
• 3. Çalt S, Serper A. Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide. J Endod. 1999;25:431-3.
• 4. Phillips M, McClanahan S, Bowles W. A titration model for evaluating calcium hydroxide removal techniques. J Appl Oral Sci. 2015;23:94-100.
• 5. Bolles JA, He J, Svoboda KKH, Schneiderman E, Glickman GN. Comparison of vibringe, endoactivator, and needle irrigation on sealer penetration in extracted human teeth. J Endod. 2013;39:708-11.
• 6. Haapasalo M, Shen Y, Wang Z, et al. Apical pressure created during irrigation with the GentleWaveTM system compared to conventional syringe irrigation. Clin Oral Investig. 2016;20:1525-34.
• 7. Taşdemir T, Çelik D, Er K, Yildirim T, Ceyhanli KT, Yeşilyurt C. Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals. Int Endod J. 2011;44:505-9.
• 8. Van Der Sluis LWM, Wu MK, Wesselink PR. The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J. 2007;40:52-57.
• 9. Jiang LM, Verhaagen B, Versluis M, Van Der Sluis LWM. Influence of the Oscillation Direction of an Ultrasonic File on the Cleaning Efficacy of Passive Ultrasonic Irrigation. J Endod. 2010;36:1372-6.
• 10. Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod. 1999;25:735-8.
• 11. Caron G, Nham K, Bronnec F, MacHtou P. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod. 2010;36:1361-6.
• 12. Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A. Antibacterial Efficacy of a New Sonic Irrigation Device for Root Canal Disinfection. J Endod. 2016;42:1799-803.
• 13. Conde AJ, Estevez R, Loroño G, Valencia de Pablo, Rossi-Fedele G, Cisneros R. Effect of sonic and ultrasonic activation on organic tissue dissolution from simulated grooves in root canals using sodium hypochlorite and EDTA. Int Endod J. 2017;50:976-82.
• 14. Alves FRF, Marceliano-Alves MF, Sousa JCN, Silveira SB, Provenzano JC, Siqueira JF. Removal of root canal fillings in curved canals using either reciprocating single- or rotary multi-instrument systems and a supplementary step with the XP-Endo Finisher. J Endod. 2016;42:1114-9.
• 15. Wigler R, Dvir R, Weisman A, Matalon S, Kfir A. Efficacy of XP-endo finisher files in the removal of calcium hydroxide paste from artificial standardized grooves in the apical third of oval root canals. Int Endod J. 2017;50:700-5.
• 16. Turkaydin D, Basturk FB, Goker S, Tarcin B, Berker YG, Ovecoglu HS. Efficacy of Endoactivator, CanalBrush, and passive ultrasonic irrigation in the removal of calcium hydroxide paste with iodoform and p-chlorophenol from root canals. Niger J Clin Pract. 2020;23:1237-42.
• 17. Urban K, Donnermeyer D, Schäfer E, Bürklein S. Canal cleanliness using different irrigation activation systems: a SEM evaluation. Clin Oral Investig. 2017;21:2681-7.
• 18. Hamdan R, Michetti J, Pinchon D, Diemer F, Georgelin-Gurgel M. The XP-Endo Finisher for the removal of calcium hydroxide paste from root canals and from the apical third. J Clin Exp Dent. 2017;9:e855-60.
• 19. Kfir A, Blau-Venezia N, Goldberger T, Abramovitz I, Wigler R. Efficacy of self-adjusting file, XP-endo finisher and passive ultrasonic irrigation on the removal of calcium hydroxide paste from an artificial standardized groove. Aust Endod J. 2018;44:26-31.
• 20. Turkaydin D, Demir E, Basturk FB, Sazak Övecoglu H. Efficacy of XP-Endo Finisher in the Removal of Triple Antibiotic Paste from Immature Root Canals. J Endod. 2017;43:1528-31.
• 21. Zupanc J, Vahdat-Pajouh N, Schäfer E. New thermomechanically treated NiTi alloys – a review. Int Endod J. 2018;51:1088-103.
• 22. Marques-da-Silva B, Alberton CS, Tomazinho FSF, et al. Effectiveness of five instruments when removing calcium hydroxide paste from simulated internal root resorption cavities in extracted maxillary central incisors. Int Endod J. 2020;53:366-75.
• 23. Donnermeyer D, Wyrsch H, Bürklein S, Schäfer E. Removal of Calcium Hydroxide from Artificial Groo-ves in Straight Root Canals: Sonic Activation Using EDDY Versus Passive Ultrasonic Irrigation and XPen-do Finisher. J Endod. 2019;45:322-6.
• 24. Rödig T, Bozkurt M, Konietschke F, Hülsmann M. Comparison of the vibringe system with syringe and passive ultrasonic irrigation in removing debris from simulated root canal irregularities. J Endod. 2010;36:1410-3.
• 25. Arslan H, Akcay M, Capar ID, Saygili G, Gok T, Ertas H. An in vitro comparison of irrigation using photon-initiated photoacoustic streaming, ultrasonic, sonic and needle techniques in removing calcium hydroxide. Int Endod J. 2015;48:246-51.
• 26. Da Silva JM, Silveira A, Santos E, Prado L, Pessoa OF. Efficacy of sodium hypochlorite, ethylenediaminetetraacetic acid, citric acid and phosphoric acid in calcium hydroxide removal from the root canal: A microscopic cleanliness evaluation. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2011;112:820-4.