AŞAMALI ÇÜRÜK TEDAVİSİ

Year 2018, Volume: 5 Issue: 2, 177 - 185, 01.08.2018

Fatma Dilsad Oz Saadet Gökalp

https://doi.org/10.15311/selcukdentj.337781

Abstract

Günümüzde diş dokusunun
sağlıklı olarak kalmasında pulpanın önemi daha iyi anlaşıldıkça, diş hekimleri
çürük temizlenmesi sırasında pulpa ekspoz olsa bile pulpanın canlılığının
korunması için daha çok çaba sarf etmeye başlamışlardır. Çünkü pulpasız dişlerde
dişin kırılması gibi kritik komplikasyonlar ortaya çıkabilmektedir. Diş
hekimliği uygulamalarında diş hekimleri, eğer çürük tamamen uzaklaştırılacaksa
pulpa ekspozu ile sonuçlanabilecek derin çürüklerle çok sık karşılaşırlar.
Pulpanın doğal rejenerasyon yeteneğinin çok yüksek olduğu araştırmacılar
tarafından gözlenmektedir. Direk pulpa kaplaması tipik olarak pulpanın
korunması için uygulanır. Bununla birlikte çürük kaldırılmasına bağlı olarak
ekspoz olan pulpaya direk pulpa kaplaması uygulamasına alternatif olarak çürük
dokunun tamamı kaldırılmadan ilk randevude yumuşak dentinin sadece bir kısmı
kaldırılarak kavite  geçici restore
edilir ve bir süre sonra tekrar açılır. İleri ekskavasyon bu randevuda yapılır
ve kavite kalıcı olarak restore edilir. Bu uygulamanın amacı lezyonun
ilerlemesini durdurmaktır ve pulpal ekspoz olmadan tersiyer dentin oluşumuna
izin vermektir. Bu tedavi yöntemi ile ilgili literatürde bulunan pek çok
çalışma incelenerek tedavinin prognozu hakkında bilgi edinilmiştir.

Keywords

derin dentin çürüğü, direkt kuafaj, indirekt kuafaj, aşamalı çürük tedavisi

References

• Kaynaklar 1. Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA. The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study. J Am Dent Assoc 2006;137:1699-705.
• 2. Barthel CR, Rosenkranz B, Leuenberg A, Roulet JF. Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 2000;26:525-8.
• 3. Haskell EW, Stanley HR, Chellemi J, Stringfellow H. Direct pulp capping treatment: a long-term follow-up. J Am Dent Assoc 1978;97:607-12.
• 4. Matsuo T, Nakanishi T, Shimizu H, Ebisu S. A clinical study of direct pulp capping applied to carious-exposed pulps. J Endod 1996;22:551-6.
• 5. Cohen S, Berman LH, Blanco L, Bakland L, Kim JS. A demographic analysis of vertical root fractures. J Endod 2006;32:1160-3.
• 6. Bjorndal L. The caries process and its effect on the pulp: the science is changing and so is our understanding. J Endod 2008;34:2-5.
• 7. Kidd E. The Cartwright Prize. Caries removal and the pulpo-dentinal complex. Dent Update 2000;27:476-82.
• 8. Kidd EA. How 'clean' must a cavity be before restoration? Caries Res 2004;38:305-13.
• 9. Ranly DM, Garcia-Godoy F. Current and potential pulp therapies for primary and young permanent teeth. J Dent 2000;28:153-61.
• 10. Oguntebi BR. Dentine tubule infection and endodontic therapy implications. Int Endod J 1994;27:218-22.
• 11. Thompson V, Craig RG, Curro FA, Green WS, Ship JA. Treatment of deep carious lesions by complete excavation or partial removal: a critical review. J Am Dent Assoc 2008;139:705-12.
• 12. GV. B. A Work on Operative Dentistry. Volume 2: The Technical Procedures in Filling Teeth. : Chicago: Medico-Dental Publishing Company; 1908.
• 13. Bodecker CF. Histologic evidence of the benefits of temporary fillings and successful pulp capping of deciduous teeth. . J Am Dent Assoc 1938;25:777–86.
• 14. Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A, et al. Attitudes and expectations of treating deep caries: a PEARL Network survey. Gen Dent 2007;55:197-203.
• 15. Qudeimat MA, Al-Saiegh FA, Al-Omari Q, Omar R. Restorative treatment decisions for deep proximal carious lesions in primary molars. Eur Arch Paediatr Dent 2007;8:37-42.
• 16. Bjorndal L, Larsen T. Changes in the cultivable flora in deep carious lesions following a stepwise excavation procedure. Caries Res 2000;34:502-8.
• 17. Bjorndal L, Larsen T, Thylstrup A. A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals. Caries Res 1997;31:411-7.
• 18. Bjorndal L, Thylstrup A. A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study. Community Dent Oral Epidemiol 1998;26:122-8.
• 19. Leksell E, Ridell K, Cvek M, Mejare I. Pulp exposure after stepwise versus direct complete excavation of deep carious lesions in young posterior permanent teeth. Endod Dent Traumatol 1996;12:192-6.
• 20. Magnusson BO, Sundell SO. Stepwise excavation of deep carious lesions in primary molars. J Int Assoc Dent Child 1977;8:36-40.
• 21. Wicht MJ, Haak R, Schutt-Gerowitt H, Kneist S, Noack MJ. Suppression of caries-related microorganisms in dentine lesions after short-term chlorhexidine or antibiotic treatment. Caries Res 2004;38:436-41.
• 22. Ricketts D. Management of the deep carious lesion and the vital pulp dentine complex. Br Dent J 2001;191:606-10.
• 23. Maltz M, de Oliveira EF, Fontanella V, Bianchi R. A clinical, microbiologic, and radiographic study of deep caries lesions after incomplete caries removal. Quintessence Int 2002;33:151-9.
• 24. Ogawa F, Machida Y. Clinical observation of indirect pulp capping in deep carious lesions. Shikwa Gakuho 1984;84:1963-70.
• 25. Law DB, Lewis TM. The effect of calcium hydroxide on deep carious lesions. Oral Surg Oral Med Oral Pathol 1961;14:1130-7.
• 26. Hayashi M, Fujitani M, Yamaki C, Momoi Y. Ways of enhancing pulp preservation by stepwise excavation--a systematic review. J Dent 2011;39:95-107.
• 27. Maltz M, Oliveira EF, Fontanella V, Carminatti G. Deep caries lesions after incomplete dentine caries removal: 40-month follow-up study. Caries Res 2007;41:493-6.
• 28. Wei S, Sadr A, Shimada Y, Tagami J. Effect of caries-affected dentin hardness on the shear bond strength of current adhesives. J Adhes Dent 2008;10:431-40.
• 29. Yoshiyama M, Doi J, Nishitani Y, Itota T, Tay FR, Carvalho RM, et al. Bonding ability of adhesive resins to caries-affected and caries-infected dentin. J Appl Oral Sci 2004;12:171-6.
• 30. Yoshiyama M, Tay FR, Doi J, Nishitani Y, Yamada T, Itou K, et al. Bonding of self-etch and total-etch adhesives to carious dentin. J Dent Res 2002;81:556-60.
• 31. Sawusch RH. Direct and indirect pulp capping with two new products. J Am Dent Assoc 1982;104:459-62.
• 32. Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011;44:697-730.
• 33. Kerkhove BC, Jr., Herman SC, Klein AI, McDonald RE. A clinical and television densitometric evaluation of the indirect pulp capping technique. J Dent Child 1967;34:192-201.
• 34. Fairbourn DR, Charbeneau GT, Loesche WJ. Effect of improved Dycal and IRM on bacteria in deep carious lesions. J Am Dent Assoc 1980;100:547-52.
• 35. Bjorndal L, Reit C, Bruun G, Markvart M, Kjaeldgaard M, Nasman P, et al. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 2010;118:290-7.
• 36. Maltz M, Alves LS, Jardim JJ, Moura Mdos S, de Oliveira EF. Incomplete caries removal in deep lesions: a 10-year prospective study. Am J Dent 2011;24:211-4.
• 37. King JB, Jr., Crawford JJ, Lindahl RL. Indirect pulp capping: a bacteriologic study of deep carious dentine in human teeth. Oral Surg Oral Med Oral Pathol 1965;20:663-9.
• 38. Handelman SL, Washburn F, Wopperer P. Two-year report of sealant effect on bacteria in dental caries. J Am Dent Assoc 1976;93:967-70.
• 39. Kreulen CM, de Soet JJ, Weerheijm KL, van Amerongen WE. In vivo cariostatic effect of resin modified glass ionomer cement and amalgam on dentine. Caries Res 1997;31:384-9.
• 40. Bonecker M, Toi C, Cleaton-Jones P. Mutans streptococci and lactobacilli in carious dentine before and after Atraumatic Restorative Treatment. J Dent 2003;31:423-8.
• 41. Lula EC, Monteiro-Neto V, Alves CM, Ribeiro CC. Microbiological analysis after complete or partial removal of carious dentin in primary teeth: a randomized clinical trial. Caries Res 2009;43:354-8.
• 42. Orhan AI, Oz FT, Ozcelik B, Orhan K. A clinical and microbiological comparative study of deep carious lesion treatment in deciduous and young permanent molars. Clin Oral Investig 2008;12:369-78.
• 43. Lula EC, Almeida LJ, Jr., Alves CM, Monteiro-Neto V, Ribeiro CC. Partial caries removal in primary teeth: association of clinical parameters with microbiological status. Caries Res 2011;45:275-80.
• 44. Leung RL, Loesche WJ, Charbeneau GT. Effect of Dycal on bacteria in deep carious lesions. J Am Dent Assoc 1980;100:193-7.
• 45. Ribeiro J, Ericson D. In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements. Scand J Dent Res 1991;99:533-40.
• 46. Hori R, Kohno S, Hoshino E. Bactericidal eradication from carious lesions of prepared abutments by an antibacterial temporary cement. J Prosthet Dent 1997;77:348-52.
• 47. van Lunsen DM, de Soet JJ, Weerheijm KL, Groen HJ, Veerkamp JS. Effects of dental treatment and single application of a 40% chlorhexidine varnish on mutans Streptococci in young children under intravenous anaesthesia. Caries Res 2000;34:268-74.
• 48. Botelho MG. The minimum inhibitory concentration of oral antibacterial agents against cariogenic organisms. Microbios 2000;103:31-41.
• 49. Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol 1993;8(3):172-6.
• 50. Weiner R. Liners and bases in general dentistry. Aust Dent J 2011;56:11-22.
• 51. Torneck CD, Moe H, Howley TP. The effect of calcium hydroxide on porcine pulp fibroblasts in vitro. J Endod 1983;9:131-6.
• 52. Meeker HG, Najafi MM, Linke HA. Germicidal properties of dental cavity liners, bases, and cements. Gen Dent 1986;34:474-8.
• 53. Anderson RW, Powell BJ, Pashley DH. Microleakage of IRM used to restore endodontic access preparations. Endod Dent Traumatol 1990;6:137-41.
• 54. Jordan RE, Suzuki M. Conservative treatment of deep carious lesions. J Can Dent Assoc (Tor) 1971;37:337-42.
• 55. Lin A, McIntyre NS, Davidson RD. Studies on the adhesion of glass-ionomer cements to dentin. J Dent Res 1992;71:1836-41.
• 56. Marchi JJ, de Araujo FB, Froner AM, Straffon LH, Nor JE. Indirect pulp capping in the primary dentition: a 4 year follow-up study. J Clin Pediatr Dent 2006;31:68-71.
• 57. Johnson BR. Considerations in the selection of a root-end filling material. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:398-404.
• 58. Cho BH, Dickens SH, Bae JH, Chang CG, Son HH, Um CM. Effect of interfacial bond quality on the direction of polymerization shrinkage flow in resin composite restorations. Oper Dent 2002;27:297-304.
• 59. Ribeiro CC, Baratieri LN, Perdigao J, Baratieri NM, Ritter AV. A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. Quintessence Int 1999;30:591-9.