Kemomekanik Çürük Temizleme Yönteminin Farklı Restoratif Materyallerin Adezyonuna Etkisinin İncelenmesi

Yıl 2024, , 214 - 225, 28.08.2024

Özge Gülcü Kılınçaslan Derya Ceyhan

https://doi.org/10.22312/sdusbed.1497145

Öz

Amaç: Bu çalışmanın amacı, kemomekanik yöntem ve atravmatik restoratif tedavi tekniğinin, süt azı dişlerinin yüksek viskoziteli cam iyonomer siman ve kompomer ile restorasyonları üzerinde çalışma süresi, mikro-gerilim bağlanma dayanımı ve mikrosızıntı açısından etkilerinin değerlendirilmesidir.
Materyal-Metot: Toplanan 80 adet süt azı dişi, uygulanan çürük uzaklaştırma yöntemine göre Grup 1: BRIX 3000 ve Grup 2: ART olarak iki ana gruba; kullanılan restorasyon materyaline göre Grup A: Equia Forte HT ve Grup B: Dyract XP olarak iki alt gruba ayrıldı. Dişlerin çürük uzaklaştırma ve restorasyon aşamaları için harcanan süre kaydedildi. Örnekler, deney öncesinde 500 kez termal siklus işlemine tabi tutuldu. Mikro-gerilim testi ile bağlanma dayanım değerleri belirlendi, kopma tipleri değerlendirildi. Mikrosızıntı değerlendirmesi için örneklerin gingival ve okluzal boya penetrasyon derecesi incelendi. Elde edilen veriler istatistiksel olarak analiz edildi.
Bulgular: BRIX 3000 uygulanan gruplarda çürük uzaklaştırma süresi, Equia Forte HT kullanılan gruplarda restorasyon süresi daha fazlaydı (p<0,05). Mikro-gerilim bağlanma dayanımı değerinin, BRIX 3000 kullanılan tüm çalışma gruplarında, ART kullanılan çalışma gruplarına göre daha fazla olduğu saptandı (p<0,05). BRIX+Equia Forte HT çalışma grubunda en sık koheziv tip kopma, diğer çalışma gruplarında ise en sık adeziv tip kopma görüldü. Kopma türüne göre mikro-gerilim bağlanma dayanımı değerlerinin sıralamasının "koheziv>miks>adeziv" olduğu ve yalnızca adeziv ile koheziv tip kopma arasındaki farkın anlamlı olduğu bulundu (p<0,05). En düşük okluzal ve gingival mikrosızıntı skoru BRIX+Equia Forte HT grubunda, en yüksek mikrosızıntı skoru ART+Dyract XP grubunda ölçüldü (p<0,05).
Sonuç: BRIX 3000 kullanılan kemomekanik çürük uzaklaştırma yönteminin, mikro-gerilim bağlanma dayanımını ve sızdırmazlık özelliğini artırdığı görüldü. BRIX+Equia Forte HT kombinasyonu, tüm testlerde en başarılı sonuçları sundu.

Anahtar Kelimeler

Atravmatik restoratif tedavi, kemomekanik çürük uzaklaştırma, süt dişi

Etik Beyan

Bu çalışma için Süleyman Demirel Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu Başkanlığı’ndan, ‘’İlaç Dışı Araştırmalar’’ kategorisinde 16/234 sayılı karar ile izin alındı.

Destekleyen Kurum

Süleyman Demirel Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi

Proje Numarası

Süleyman Demirel Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından, Lisansüstü Tez Projesi kapsamında, TDH-2020-8287 numaralı proje desteği sağlandı.

Teşekkür

Bu çalışmayı destekleyen Süleyman Demirel Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi’ne ve laboratuvar ve analiz aşaması süresince desteklerini esirgemeyen Selçuk Üniversitesi Diş Hekimliği Fakültesi Araştırma Laboratuvarı sorumlularına teşekkürlerimizi sunarız.

Investigation of the Effect of Chemomechanical Caries Removal Method on the Adhesion of Different Restorative Materials

Öz

Objective: Aim of this study was to evaluate effects of chemomechanical method and atraumatic restorative treatment technique on working time, micro-tension bond strength and microleakage of restorations of deciduous molars with high viscosity glass ionomer cement and compomer.

Material-Method: Eighty collected deciduous molars were divided into two main groups as Group1:BRIX 3000 and Group2:ART for caries removal method and into two subgroups as GroupA:Equia Forte HT and GroupB:Dyract XP for restorative material. Time spent on caries removal and restoration was recorded. Specimens were thermal cycled 500 times before the experiment. Bond strength values were determined by micro-tension test, fracture types were evaluated. For microleakage evaluation, degree of gingival and occlusal dye penetration was examined. Data obtained were statistically analyzed.

Results: Caries removal time was longer in BRIX 3000-treated groups and restoration time was longer in Equia Forte HT-treated groups(p<0.05). Micro-tensile bond strength value was higher in all study groups using BRIX 3000 than in study groups using ART(p<0.05). In BRIX+Equia Forte HT study group, the most common type of fracture was cohesive, while in other study groups, it was adhesive. Ranking of micro-tensile bond strength values according to fracture type was “cohesive>mix>adhesive” and only difference between adhesive and cohesive fractures was significant(p<0.05). The lowest occlusal and gingival microleakage scores were measured in BRIX+Equia Forte HT group and the highest microleakage score was measured in ART+Dyract XP group(p<0.05).

Conclusion: Chemomechanical caries removal method using BRIX 3000 increased micro-tension bond strength and sealing properties. BRIX+Equia Forte HT combination offered the most successful results in all tests.

Anahtar Kelimeler

Atraumatic restorative treatment, chemomechanical caries removal, deciduous tooth

Etik Beyan

For this study, ethical approval was obtained from Clinical Research Ethics Committee of Faculty of Medicine of Suleyman Demirel University with the decision numbered 16/234 in the category of “Non-Drug Research”.

Destekleyen Kurum

Scientific Research Projects Coordination Unit of Suleyman Demirel University

Proje Numarası

Süleyman Demirel Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından, Lisansüstü Tez Projesi kapsamında, TDH-2020-8287 numaralı proje desteği sağlandı.

Teşekkür

We would like to thank Scientific Research Projects Coordination Unit of Suleyman Demirel University for supporting this study and the staff of Research Laboratory of Faculty of Dentistry of Selcuk University for their support during the laboratory and analysis phases.

Kaynakça

• [1]. DHHS. US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, M.D.: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institites of Health; 2000.
• [2]. Banerjee A, Kidd EAM, Watson TF. In vitro evaluation of five alternative methods of carious dentine excavation. Caries Research 2000;34(2):144-150.
• [3]. Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan V, Eden E. Minimal Intervention Dentistry (MID) for managing dental caries – a review: Report of a FDI task group. International Dental Journal 2012;62(5):223.
• [4]. Mhatre S, Kumar K, Sinha S, Mohammed B, Ahmed N, Thanawala EA. Chemo-mechanical method of caries removal. International Journal of Clinical Dental Science 2011;2(2):52-57.
• [5]. Frencken JE, Leal SC, Navarro MF. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview. Clinical Oral Investigations 2012;16(5):1337-1346.
• [6]. John M, Bds T, Tyas MJ. Clinical evaluation of glass-ionomer cement restorations. Journal of Applied Oral Science 2006;14(1):10-13.
• [7]. Krämer N, Frankenberger R. Compomers in restorative therapy of children: A literature review. International Journal of Paediatric Dentistry 2007;17(1):2-9.
• [8]. Mount GJ, Rory Hume W. A new cavity classification. Australian Dental Journal 1998;43(3):153-159.
• [9]. Fanning EA. A longitudinal study of tooth formation and root resorption. New Zealand Dental Journal 2008;104(2):60-61.
• [10]. Ekstrand KR, Ricketts DNJ, Kidd EAM. Reproducibility and accuracy of three methods for assessment of demineralization depth of the occlusal surface: an in vitro examination. Caries Research 1997;31(3):224-231.
• [11]. Banerjee A, Watson TF, Kidd EA. Dentine caries: Take it or leave it? Dental Update 2000;27(6):272-276.
• [12]. Eliades T, Viazis AD, Lekka M. Failure mode analysis of ceramic brackets bonded to enamel. American Journal of Orthodontics and Dentofacial Orthopedics 1993;104(1):21-26.
• [13]. Milleding P. Microleakage of indirect composite inlays. An in vitro comparison with the direct technique. Acta Odontologica Scandinavica 1992;50(5):295-301.
• [14]. de Souza TF, Martins ML, Tavares-Silva CM, Fonseca-Gonçalves A, Maia LC. Treatment time, pain experience and acceptability of the technique for caries removal in primary teeth using the ART approach with or without Brix3000 papain gel: A preliminary randomised controlled clinical trial. European Archives of Paediatric Dentistry 2021;2:1-9.
• [15]. Elfeel NM, Aboelmaaty MM, Mostafa MH, El-Sayed SR. Evaluation of the efficacy of minimal ınvasive methods versus conventional methods for caries removal in primary molars. Cureus 2023;15(12):e50803.
• [16]. Gupta N, Chowdhary N, Reddy VR, Nk K, Peddi R, Kumar M. Evaluation of caries removal efficacy using brıx 3000 and atraumatic restorative treatment in primary molars: a clinical comparative study. J Contemp Dent Pract 2022;23(4):419-424.
• [17]. Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial. Journal of Dentistry 2020;93:103280.
• [18]. Abdul Khalek AMG, Elkateb MA, Abdel Aziz WE, el Tantawi M. Effect of papacarie and alternative restorative treatment on pain reaction during caries removal among children: A randomized controlled clinical trial. Journal of Clinical Pediatric Dentistry 2017;41(3):219-224.
• [19]. Mhaville RJ, van Amerongen WE, Mandari GJ. Residual caries and marginal integrity in relation to Class II glass ionomer restorations in primary molars. European Archives of Paediatric Dentistry 2006;7(2):81-84.
• [20]. Gianini RJ, do Amaral FLB, Flório FM, Basting RT. Microtensile bond strength of etch-and-rinse and self-etch adhesive systems to demineralized dentin after the use of a papain-based chemomechanical method. American Journal of Dentistry 2010;23(1):23-28.
• [21]. Amaral FLB, Colucci V, Palma-Dibb RG, Corona SAM. Assessment of in vitro methods used to promote adhesive interface degradation: A critical review. Journal of Esthetic and Restorative Dentistry 2007;19(6):340-353.
• [22]. Banerjee A, Kellow S, Mannocci F, Cook RJ, Watson TF. An in vitro evaluation of microtensile bond strengths of two adhesive bonding agents to residual dentine after caries removal using three excavation techniques. Journal of Dentistry 2010;38(6):480-489.
• [23]. Zaghloul NM. Bonding capacity of a universal adhesive in different etching modes to caries affected dentin prepared by two caries excavation techniques. Egyptian Dental Journal 2018;64(4):47-59.
• [24]. Zaffe D, Botticelli A, Bellincampi M, Chiesa M, Vitale M. Carious dentin treatment for glass ionomer cement adhesion: A comparative study. WebMedCentral Dentistry 2010;1(10):001091.
• [25]. al Shamim A, Ali B, Mirza A, Khan I. Shear bond strength of conventional glass ionomer cement to mechanically treated versus chemomechanically treated dentin. Journal of Pakistan Dental Association 2010;19(3):139-143.
• [26]. Maru VP, Shakuntala BS, Dharma N. Evaluation of marginal leakage and shear bond strength of bonded restorations in primary teeth after caries removal by conventional and chemomechanical techniques. International Scholarly Research Notices 2014;2014:854816.
• [27]. Aslam S, Khan SA, Sarwar N, Rafique MA. Comparison of microleakage in chemically bonded and mechanically bonded restorations after using chemomechanical caries removal technique in primary teeth. Annals of King Edward Medical University 2021;27(1):355-361.
• [28]. Hafez MA, Elkateb M, el Shabrawy S, Mahmoud A, el Meligy O. Microleakage evaluation of composite restorations following papain-based chemo-mechanical caries removal in primary teeth. Journal of Clinical Pediatric Dentistry 2017;41(1):53-61.
• [29]. Pavuluri C, Nuvvula S, Kamatham RL, Nirmala S. Comparative evaluation of microleakage in conventional and RMGIC restorations following conventional and chemomechanical caries removal: An in vitro study. International Journal of Clinical Pediatric Dentistry 2014;7(3):172.
• [30]. Nouzari A, Zohrei A, Ferooz M, Mohammadi N. Marginal micro-leakage of self-etch and all-in one adhesives to primary teeth, with mechanical or chemo-mechanical caries removal. Journal of Dental Biomaterials 2016;3(2):220.
• [31]. Puckett AD, Fitchie JG, Karns L, Dellinger TM, Inman CC. Microleakage of a compomer compared to conventional and hybrid ionomers. Quintessence International 2001;32:49-54.
• [32]. Mosharrafian S, Heidari A, Rahbar P, Rahbar P. Microleakage of two bulk fill and one conventional composite in Class II restorations of primary posterior teeth. Journal of Dentistry 2017;14(3):123.
• [33]. Habib SI, Yassen AA, Bayoumi RE. Influence of nanocoats on the physicomechanical properties and microleakage of bulk-fill and resin-modified glass ionomer cements: An in vitro study. Journal of Contemporary Dental Practice 2021;22(1):62-68.