Farklı Yıkama Solüsyonlarının Dentin Dezenfeksiyonuna Etkisinin İncelenmesi

Year 2023, Volume: 10 Issue: 1, 21 - 29, 27.04.2023

Özlem Kahveci , Ayçe Ünverdi Eldeniz

https://doi.org/10.15311/selcukdentj.1069290

Cited By: 1

Abstract

Amaç:Bu çalışmanın amacı, yıkama solüsyonları (Serum fizyolojik, %5.25 NaOCl, Klorhex®, SmearClear) ile aleti (ProFile) kullanımının Enterococcus faecalis üzerine dezenfeksiyon etkinliğinin karşılaştırılmasıdır.
Gereç ve Yöntemler: Çalışmamızda düz, tek kanallı çekilmiş 46 adet diş kullanıldı. Dişlerin kuronları uzaklaştırıldıktan sonra, apikal açıklık 20 numaralı K-file eğe ile kontrol edildi. Dişler, 121°C’de 20 dakika steril edilmeden önce, varolan smear tabakası sırasıyla 17% EDTA ve %5.25 NaOCl 4 dakika kullanılarak uzaklaştırıldı. Daha sonra tüm diş kökleri 21 gün boyunca 37 °C’de E. faecalis ile enfekte edildi. Kullanılan yıkama solüsyonuna göre rastgele 4 eşit gruba ayrıldı (n:11).Kemomekanik preparasyon sonrasında canlılığını koruyan E. faecalis kök kanal boşluğunun iç kanal duvarlarından dentin talaşıyla toplandı ve sulandırıldı. Triptik soy agar bulunan petri kaplarına ekilerek değerlendirildi. Petri kabı üzerindeki koloniler 24-48 saat sonra sayıldı ve log10 değerlere çevrildi. Dentin talaşı toplamadan önce her gruptan bir diş, taramalı elektron mikroskobu ile değerlendirildi. Sonuçlar, Kruskal Wallis ve Bonferroni düzeltmeli Mann-Whitney U Testi ile analiz edildi.
Çalışmamızın ikinci bölümünde, kök ucundan taşan debris ve yıkama solüsyonları cam şişelere toplandı. Yıkama solüsyonlarının buharlaşmasını takiben, kuru debris ve tuz çökeltileri şişelerle tartıldı, sonuçlar kaydedildi. Veriler Kruskal Wallis ve Bonferroni düzeltmeli Mann-Whitney U Testi ile istatistiksel olarak analiz edildi.
Bulgular:E. faecalis’in kök kanallarından uzaklaştırılmasında. bakımından kullanılan test solüsyonları arasında hiçbir korelasyon bulunmadığı sonucuna varıldı.
Klorhex® solüsyonunun kullanımı ile kök ucundan çıkan debris miktarı serum fizyolojik ve SmearClear solüsyonlarının kullanımıyla taşan miktardan daha az olduğu saptandı (P<0.05).
Sonuç:Sonuç olarak, irrigasyon solüsyonu seçiminin kök ucundan taşan debris üzerinde etkisi olabilir.
Anahtar Sözcükler: kök kanal preparasyonu; döner aletler; yıkama; apikal debris;
Enterococcus faecalis.

Keywords

Kök kanal preparasyonu, yıkama, Entrococcus Feacalis

Supporting Institution

Selçuk Üniversitesi BAP Koordinatörlüğü

Project Number

062020233

References

• 1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340-9.
• 2. Matusow RJ. Acute pulpal-aleveolar cellulitis syndrome. I. Clinical study of bacterial isolates from pulps and exudates of intact teeth, with description of a specific culture technique. Oral Surg Oral Med Oral Pathol. 1979;48:70-6.
• 3. Gomes BP, Pinheiro ET, Gadê-Neto CR, Sousa EL, Ferraz CC, Zaia AA, Teixeira FB, Souza-Filho FJ. Microbiological examination of infected dental root canals. Oral Microbiol Immunol. 2004;19:71-6.
• 4. Sundqvist G. Ecology of the root canal flora. J Endod. 1992;18:427-30.
• 5. Molander A, Reit C, Dahlén G, Kvist T. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J. 1998;31:1-7.
• 6. Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:86 –93.
• 7. Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J. 2001;34:429-34.
• 8. Pinheiro ET, Gomes BP, Ferraz CC, Sousa EL, Teixeira FB, Souza-Filho FJ. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J. 2003;36:1-11.
• 9. Tennert C, Fuhrmann M, Wittmer A, Karygianni L, Altenburger MJ, Pelz K, Hellwig E, Al-Ahmad A. New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings. J Endod. 2014 May;40(5):670-7.
• 10. Byström A, Sundqvist G. Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy. Oral Surg Oral Med Oral Pathol. 1983;55:307-12.
• 11. Barnett F, Trope M, Khoja M, Tronstad L. Bacteriologic status of the root canal after sonic, ultrasonic and hand instrumentation. Endod Dent Traumatol. 1985;1:228-31.
• 12. Nair PN, Sjögren U, Krey G, Kahnberg KE, Sundqvist G. Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study. J Endod. 1990;16:580-8.
• 13. Sirén EK, Haapasalo MP, Ranta K, Salmi P, Kerosuo EN. Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation. Int Endod J. 1997;30:91-5.
• 14. Alghamdi F, Shakir M. The Influence of Enterococcus faecalis as a Dental Root Canal Pathogen on Endodontic Treatment: A Systematic Review. Cureus. 2020 Mar 13;12(3):e7257.
• 15. Akbulut M. B., Güneşer MB, Eldeniz AÜ.451,0 Farklı antiseptik taşıyıcı ve kalsiyum hidroksit kombinasyonlarının doku çözücü etkinliğinin incelenmesi. Selcuk Dental Journal. 2017; 4(1): 1-5
• 16. Brown DC, Moore BK, Brown CE Jr, Newton CW. An in vitro study of apical extrusion of sodium hypochlorite during endodontic canal preparation. J Endod. 1995;21:587-91.
• 17. Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J. 2014 Mar;216(6):299-303.
• 18. Grossman LI. Irrigation of root canals. J Am Dent Assoc. 1943;30:1915-7.
• 19. Levine JM. Dakin's solution: past, present, and future. Adv Skin Wound Care. 2013 Sep;26(9):410-4.
• 20. Siqueira JF Jr, Machado AG, Silveira RM, Lopes HP, de Uzeda M. Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal, in vitro. Int Endod J. 1997;30:279-82.
• 21. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147–79. (İçinde: Zehnder M.Root canal irrigants. J Endod. 2006;32:389- 98).
• 22. Mohammadi Z. Sodium hypochlorite in endodontics: An update review. International Dental Journal. 2008;58(6):329–341. 23. Frais S, Ng YL, Gulabivala K. Some factors affecting the concentration of available chlorine in commercial sources of sodium hypochlorite. Int Endod J. 2001;34:206-15.
• 24. Davies GE, Francis J, Martin AR, Rose FL, Swain G. 1:6-Di-4= chlorophenyldiguanidohexane(hibitane); laboratory investigation of a new antibacterial agent of high potency. Br J Pharmacol Chemother. 1954;9:192-6. (İçinde: Zehnder M. Root canal irrigants. J Endod. 2006;32:389-98).
• 25. Zamany A, Safavi K, Spångberg LS. The effect of chlorhexidine as an endodontic disinfectant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:578-81.
• 26. Gomes BP, Vianna ME, Zaia AA, Almeida JF, Souza-Filho FJ, Ferraz CC. Chlorhexidine in endodontics. Braz Dent J. 2013;24(2):89-102.
• 27. Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. J Endod. 1998;24:472-6.
• 28. Rosenthal S, Spångberg L, Safavi K. Chlorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98:488-92.
• 29. Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod. 2006 Nov;32(11):1091-3..
• 30. Lawrance HR. Near field sound pressure level measurements around an air-cooled exchanger. Am Ind Hyg Assoc J. 1970;31:377-82.
• 31. D'Arcangelo C, Varvara G, De Fazio P. An evaluation of the action of different root canal irrigants on facultative aerobic-anaerobic, obligate anaerobic, and microaerophilic bacteria. J Endod. 1999;25:351-3.
• 32. Khedmat S, Aligholi M, Sadeghi S. Influence of Bovine Serum Albumin on the Antibacterial Activity of Endodontic Irrigants against Enterococcus Faecalis. Iran Endod J. 2009 Fall;4(4):139-43. Epub 2009 Oct 10.
• 33. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. J Endod. 1985;11:472-8.
• 34. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J. 2014 Mar;47(3):211-21.
• 35. Siqueira JF Jr. Microbial causes of endodontic flare-ups. Int Endod J. 2003;36:453-63.
• 36. Fairbourn DR, McWalter GM, Montgomery S. The effect of four preparation techniques on the amount of apically extruded debris. J Endod. 1987;13:102-8
• 37. Williams CE, Reid JS, Sharkey SW, Saunders WP. In-vitro measurement of apically extruded irrigant in primary molars. Int Endod J. 1995;28:221-5.
• 38. Tanalp J, Kaptan F, Sert S, Kayahan B, Bayırlı G. Quantitative evaluation of the amount of apically extruded debris using 3 different rotary instrumentation systems. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:250-7.
• 39. Kuştarci A, Akpinar KE, Er K. Apical extrusion of intracanal debris and irrigant following use of various instrumentation techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:257-62.
• 40. Western JS, Dicksit DD. Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis. J Conserv Dent. 2017 Jan-Feb;20(1):30-36.
• 41. Gummadi A, Panchajanya S, Ashwathnarayana S, Santhosh L, Jaykumar T, Shetty A. Apical extrusion of debris following the use of single-file rotary/reciprocating systems, combined with syringe or ultrasonically-facilitated canal irrigation. J Conserv Dent. 2019 Jul-Aug;22(4):351-355.
• 42. Elashiry MM, Saber SE, Elashry SH. Apical extrusion of debris after canal shaping with three single-file systems. Niger J Clin Pract. 2020 Jan;23(1):79-83.
• 43. Tanriverdi F, Esener T, Erganiş O, Belli S. An in vitro test model for investigation of disinfection of dentinal tubules infected with Enterococcus faecalis. Braz Dent J. 1997;8:67-72.
• 44. Eldeniz AU, Ozer F, Hadimli HH, Erganis O. Bactericidal efficacy of Er,Cr:YSGG laser irradiation against Enterococcus faecalis compared with NaOCl irrigation: an ex vivo pilot study. Int Endod J. 2007;40:112-9.
• 45. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58:589-99.
• 46. Saleh IM, Ruyter IE, Haapasalo M, Ørstavik D. Survival of Enterococcus faecalis in infected dentinal tubules after root canal filling with different root canal sealers in vitro. Int Endod J. 2004;37:193-8.
• 47. Oliveira DP, Barbizam JV, Trope M, Teixeira FB. In vitro antibacterial efficacy of endodontic irrigants against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:702-6.
• 48. Lin S, Kfir A, Laviv A, Sela G, Fuss Z. The in vitro antibacterial effect of iodine- potassium iodide and calcium hydroxide in infected dentinal tubules at different time intervals. J Contemp Dent Pract. 2009;10:59-66.
• 49. Haga CS. Microscopic measurements of root canal preparations following instrumentation. J Br Endod Soc. 1968;2:41-6.
• 50. Gutiérrez JH, Garciá J. Microscopic and macroscopic investigation on results of mechanical preparation of root canals. Oral Surg Oral Med Oral Pathol. 1968;25:108-16.
• 51. Walton RE. Histologic evaluation of different methods of enlarging the pulp canal space. J Endod. 1976;2:304-11.
• 52. Tan BT, Messer HH. The quality of apical canal preparation using hand and rotary instruments with specific criteria for enlargement based on initial apical file size. J Endod. 2002;28:658-64.
• 53. Siqueira JF Jr, Araújo MC, Garcia PF, Fraga RC, Dantas CJ. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod. 1997;23:499-502.
• 54. Petschelt A, Stumpf B, Raab W.Adhesion of root canal sealers with and without smear layer. Dtsch Zahnarztl Z. 1987 Aug;42(8):743-6. German. (İçinde: Schäfer E, Schlingemann R.Efficiency of rotary nickel-titanium K3 instruments compared with stainless steel hand K-Flexofile. Part 2. Cleaning effectiveness and shaping ability in severely curved root canals of extracted teeth. Int Endod J. 2003;36:208-17).
• 55. West JD, Roane JB, Goering AC. Cleaning and shaping the root canal system. In:Cohen S Burn RC,eds.Pathways of the Pulps. 6th ed. St Louis, USA:Mosby Year Book. 1994, p.179-218.
• 56. Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation. J Endod. 1997;23:301-6.
• 57. Gambarini G. Shaping and cleaning the root canal system: a scanning electron microscopic evaluation of a new instrumentation and irrigation technique. J Endod. 1999;25:800-3.
• 58. Grandini S, Balleri P, Ferrari M. Evaluation of Glyde File Prep in combination with sodium hypochlorite as a root canal irrigant. J Endod. 2002;28:300-3.
• 59. Haapasalo M, Ørstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987;66:1375-9.
• 60. Boutsioukis C, Psimma Z, van der Sluis LW. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J. 2013 Jul;46(7):599-618