Enstrümantasyon sırasında seçilen farklı tork ayarlarının endodontik tedavi görmüş dişlerin kırılma dayanımına etkisi

Abstract

Amaç: Bu çalışma, düşük ve yüksek tork ayarlarında yapılan kök kanal enstrümantasyonunun endodontik tedavi görmüş dişlerin kırılma dayanımı üzerindeki etkisini değerlendirdi. Gereç ve Yöntemler: Doksan adet çekilmiş tek köklü insan mandibular kesici dişi rastgele bir kontrol (CG) ve iki deney grubuna ayrıldı (n=30): enstrümantasyon veya kök kanal dolumu yok (CG), düşük tork ayarlarında ProTaper Universal eğelerle enstrümantasyon ve yüksek tork ayarlarında ProTaper Universal eğelerle enstrümantasyon. Deney gruplarında kök kanalları epoksi rezin esaslı pat ve güta-perka ile tek kon tekniği kullanılarak dolduruldu. Her örnek kırılma dayanımı açısından test edildi. Varyans analizi ve Tukey testi elde edilen verilerin analizinde kullanıldı. Anlamlılık düzeyi 0.05 olarak belirlendi. Bulgular: Gruplar arasında istatistiksel olarak anlamlı farklılıklar gözlendi (p = 0.001). CG ve düşük tork grupları arasındaki fark anlamlı değilken (p > 0.05), CG ve yüksek tork, düşük ve yüksek tork grupları arasındaki fark anlamlıydı (p < 0.05). Sonuç: Bu çalışmanın bulgularına göre, yüksek tork grubunda en düşük kırılma dayanımı değeri gözlemlendiğinden, klinisyenlere üreticilerin döner sistemler için önerdiği en düşük tork ayarlarını seçmeleri önerilebilir.

Keywords

• Endodonti
• kök kanal preparasyonu
• tork

Effect of different torque settings selected during instrumentation on fracture strength of endodontically treated teeth

Abstract

Background: The study evaluated the effect of root canal instrumentation at low and high torque settings on the fracture strength of endodontically treated teeth. Methods: Ninety extracted single-rooted human mandibular incisors were randomly divided into one control (CG) and two experimental groups (n=30): no instrumentation or filling (CG), instrumentation with ProTaper Universal files at low torque settings, and instrumentation with ProTaper Universal files at high torque settings. Root canal filling was performed with an epoxy resin-based sealer and gutta-percha using a single-cone technique in the experimental groups. Each specimen was tested for fracture strength. The analysis of variance and Tukey test were used to analyze the obtained data. The significance level was set at 0.05. Results: Statistically significant differences were observed between the groups (p = 0.001). While the difference between the CG and low torque groups was not significant (p > 0.05), the difference between the CG and high torque, low and high torque groups was significant (p < 0.05). Conclusion: According to this study results, since the lowest fracture strength value was observed in the high torque group, clinicians may be advised to choose the lowest torque settings recommended by the manufacturers for rotary systems.

Keywords

• Endodontics
• Root canal preparation
• torque

References

1. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004;30:559-67.
2. Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J 2005;38:725-34.
3. Hulsmann M, Schade M, Schafers F. A comparative study of root canal preparation with HERO 642 and Quantec SC rotary Ni-Ti instruments. Int Endod J 2001;34:538-46.
4. Rodig T, Wagner J, Wiegand A, Rizk M. Efficacy of the ProTaper retreatment system in removing Thermafil, GuttaCore or vertically compacted gutta-percha from curved root canals assessed by micro-CT. Int Endod J 2018;51:808-15.
5. Turk T, Kaval ME, Sarikanat M, Hulsmann M. Effect of final irrigation procedures on fracture resistance of root filled teeth: an ex vivo study. Int Endod J 2017;50:799-804.
6. Uzunoglu E, Yilmaz Z, Erdogan O, Gorduysus M. Final Irrigation Regimens Affect Fracture Resistance Values of Root-filled Teeth. J Endod 2016;42:493-5.
7. Burklein S, Tsotsis P, Schafer E. Incidence of dentinal defects after root canal preparation: reciprocating versus rotary instrumentation. J Endod 2013;39:501-4.
8. Keles A, Keskin C, Karataslioglu E, Kishen A, Versiani MA. Middle Mesial Canal Preparation Enhances the Risk of Fracture in Mesial Root of Mandibular Molars. J Endod 2020;46:1323-9.

9. Chai H, Tamse A. The Effect of Isthmus on Vertical Root Fracture in Endodontically Treated Teeth. J Endod 2015;41:1515-9.
10. Ersoy I, Evcil MS. Evaluation of the effect of different root canal obturation techniques using two root canal sealers on the fracture resistance of endodontically treated roots. Microsc Res Tech 2015;78:404-7.
11. Adorno CG, Yoshioka T, Suda H. The effect of root preparation technique and instrumentation length on the development of apical root cracks. J Endod 2009;35:389-92.
12. Kim HC, Sung SY, Ha JH, Solomonov M, Lee JM, Lee CJ, et al. Stress generation during self-adjusting file movement: minimally invasive instrumentation. J Endod 2013;39:1572-5.
13. Kim HC, Lee MH, Yum J, Versluis A, Lee CJ, Kim BM. Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture. J Endod 2010;36:1195-9.
14. Ashwinkumar V, Krithikadatta J, Surendran S, Velmurugan N. Effect of reciprocating file motion on microcrack formation in root canals: an SEM study. Int Endod J 2014;47:622-7.
15. Bier CA, Shemesh H, Tanomaru-Filho M, Wesselink PR, Wu MK. The ability of different nickel-titanium rotary instruments to induce dentinal damage during canal preparation. J Endod 2009;35:236-8.
16. Acharya N, Hasan MR, Kafle D, Chakradhar A, Saito T. Effect of Hand and Rotary Instruments on the Fracture Resistance of Teeth: An In Vitro Study. Dent J (Basel) 2020;8:38.
17. Dane A, Capar ID, Arslan H, Akcay M, Uysal B. Effect of Different Torque Settings on Crack Formation in Root Dentin. J Endod 2016;42:304-6.
18. Mousavi E, Movahedi S. The Effects of Different Torques on Dentinal Crack Formation in Root Canals Using the Race Rotary System. Annals of Dental Specialty Vol 2018;6:182.
19. Gambarini G. Advantages and disadvantages of new torque-controlled endodontic motors and low-torque NiTi rotary instrumentation. Aust Endod J 2001;27:99-104.
20. Capar ID, Altunsoy M, Arslan H, Ertas H, Aydinbelge HA. Fracture strength of roots instrumented with self-adjusting file and the ProTaper rotary systems. J Endod 2014;40:551-4.
21. Prado M, de Lima NRB, de Lima CO, Gusman H, Simao RA. Resistance to vertical root fracture of root filled teeth using different conceptual approaches to canal preparation. Int Endod J 2016;49:898-904.
22. Piskin B, Aydin B, Sarikanat M. The effect of spreader size on fracture resistance of maxillary incisor roots. Int Endod J 2008;41:54-9.
23. Abou El Nasr HM, Abd El Kader KG. Dentinal damage and fracture resistance of oval roots prepared with single-file systems using different kinematics. J Endod 2014;40:849-51.
24. Karatas E, Arslan H, Alsancak M, Kirici DO, Ersoy I. Incidence of Dentinal Cracks after Root Canal Preparation with Twisted File Adaptive Instruments Using Different Kinematics. J Endod 2015;41:1130-3.
25. Yoldas O, Yilmaz S, Atakan G, Kuden C, Kasan Z. Dentinal microcrack formation during root canal preparations by different NiTi rotary instruments and the self-adjusting file. J Endod 2012;38:232-5.
26. Burklein S, Stuber JP, Schafer E. Real-time dynamic torque values and axial forces during preparation of straight root canals using three different endodontic motors and hand preparation. Int Endod J 2019;52:94-104.
27. Capar ID, Arslan H. A review of instrumentation kinematics of engine-driven nickel-titanium instruments. Int Endod J 2016;49:119-35.
28. Li SH, Lu Y, Song D, Zhou X, Zheng QH, Gao Y, et al. Occurrence of Dentinal Microcracks in Severely Curved Root Canals with ProTaper Universal, WaveOne, and ProTaper Next File Systems. J Endod 2015;41:1875-9.
29. Ceyhanli KT, Erdilek N, Tatar I, Celik D. Comparison of ProTaper, RaCe and Safesider instruments in the induction of dentinal microcracks: a micro-CT study. Int Endod J 2016;49:684-9.
30. Liu R, Hou BX, Wesselink PR, Wu MK, Shemesh H. The incidence of root microcracks caused by 3 different single-file systems versus the ProTaper system. J Endod 2013;39:1054-6.
31. Saeidi A, Hamidi M, Harandi A, Habibolahpour M, Gholinia H. Effect of different torques on dentinal crack formation following canal preparation using neoniti rotary system. Caspian J Dent Res 2018;7:8-13.