Taşkın Prepare Edilmiş Kök Kanallarında Farklı İrigasyon Uçlarının Apikalden Taşan Solusyon Miktarına Etkisi

Yıl 2025, Cilt: 14 Sayı: 1, 49 - 56, 27.01.2025

Safa Alqassab , Özgür Genç Şen

https://doi.org/10.54617/adoklinikbilimler.1563570

Öz

Bu çalışmada, apikal daralımı bozulmuş ve bozulmamış dişlerde kullanılan farklı tipte irigasyon iğnelerinin apikalden taşan solusyon miktarına etkisi değerlendirilmiştir. Kırk mandibular dişin apikal foramenleri dental operasyon mikroskobu altında belirlendi ve örnekler iki gruba ayrıldı (n=20). Gruplardan biri apikal foramene 0.5 mm mesafede, diğeri ise apikal foramenin 0.5 mm ilerisinden taşkın olarak enstrümante edildi. Her bir preparasyon grubunun final irrigasyonunda biri açık uçlu ve üçü kapalı uçlu (yandan delikli) olmak üzere dört farklı iğne kullanıldı. Tüm örnekler, randomize çapraz tasarım kullanılarak tüm iğne tipleri ile ayrı ayrı irrige edildi. İşlemler esnasında apikal bölgeye taşan solusyonlar, plastik kaplara yerleştirilmiş çiçek süngerleri içerisinde toplandı. Taşan solüsyon miktarları, kapların başlangıç ağırlıklarının son ağırlıklarından çıkarılmasıyla hesaplandı ve kaydedildi. İstatistiksel değerlendirmeler için Tekrarlanan İki Yönlü ANOVA ve Tukey post-hoc testleri kullanıldı. Taşkın enstrümantasyon yapılan gruplarda, kullanılan iğnelerden bağımsız olarak, sağlam apikal foramene sahip dişlere göre önemli ölçüde daha fazla irrigan ekstrüzyonu gerçekleşti. Sağlam apikal daralıma sahip irigasyon gruplarında ekstrüzyon miktarı çift delikli kapalı uçlu iğnede en az, açık uçlu iğne grubunda en fazlaydı. Taşkın enstrümantasyon yapılmış gruplarda, en az ekstrüzyon tek delikli iğne grubunda, en fazla ise açık uçlu iğne grubunda gözlendi. Bu çalışmanın sınırlamaları altında, taşkın enstrümantasyon yapılmış dişlerdeki irigasyon işlemleri için tek delikli kapalı uçlu iğnenin kullanımı önerilebilir.

Anahtar Kelimeler

Apikal Foramen, Diş Apeksi, Güvenlik, Kök kanal preparasyonu, Yıkama

Etik Beyan

Etik Kurul Onay Raporu dosyalar sekmesinde sunulmuştur.

Proje Numarası

Proje Yok

Effect of Different Irrigation Needle Tips on Apical Extrusion of Irrigants in Over-instrumented Root Canals

Öz

This study evaluated the effect of various irrigation needle types on the amount of apically extruded irrigant in teeth with both intact and disrupted apical constrictions. A total of 40 mandibular teeth were examined under a dental operating microscope to determine the apical foramen, and the specimens were divided into two groups (n = 20). In one group, the teeth were instrumented 0.5 mm short of the apical foramen, while in the other, the instrumentations were were done 0.5 mm beyond the apical foramen. An open-tip needle and three different types of closed-tip (side-vented) needles were used for final irrigations. All specimens were irrigated with each needle type using a randomized crossover design. The extruded irrigants were collected in plastic containers with floral foam inserts, which were weighed before and after irrigation to determine the amount of extrusion by subtracting initial weights from final weights. Statistical analysis was conducted using repeated measures of two-way ANOVA and Tukey’s post hoc tests. In the over-instrumented group, all needle types resulted in significantly higher extrusion compared to the intact apical foramen group. Among the needles, the double-side-vented needle produced the least extrusion in the intact group, while the open-tip needle produced the most. In the over-instrumented group, the one-side-vented needle resulted in the least extrusion, with the open-tip needle again causing the most. Within the limitations of this study, the one-side-vented needle is recommended for irrigation procedures in over-instrumented teeth.

Anahtar Kelimeler

Apical Foramen, Irrigation, Root canal preparation, Safety, Tooth apex

Proje Numarası

Proje Yok

Kaynakça

• Referans1. Spangberg L, Engström B, Langeland K. Biologic effects of dental materials: 3. Toxicity and antimicrobial effect of endodontic antiseptics in vitro. Oral Surg Oral Med Oral Pathol 1973;36:856- 71.
• Referans2. Gatot A, Arbelle J, Leiberman A, Yanai-Inbar I. Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex. J Endod 1991;17:573-4.
• Referans3. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long term results of endodontic treatment. J Endod 1990;16:498-504.
• Referans4. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005;10:3-29.
• Referans5. Verhaagen B, Boutsioukis C, Heijnen GL, Van der Sluis LW, Versluis M. Role of the confinement of a root canal on jet impingement during endodontic irrigation. Exp Fluids 2012;53:1841-53.
• Referans6. Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J 2014;216:299-303.
• Referans7. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod 1991;17:275-9.
• Referans8. Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:e31-5.
• Referans9. Genc Sen O, Kaya M. Comparative Safety of Needle, EndoActivator, and laser-activated irrigation in overinstrumented root canals. Photomed Laser Surg 2018;36:198-202.
• Referans10. Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022;55:153-77.
• Referans11. Uzunoglu E, Görduysus M, Görduysus Ö. A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 2015;7:e218-23.
• Referans12. Hulsmann M, Hahn W. Complications during root canal irrigation: literature review and case reports. Int Endod J 2000;33:186-193.
• Referans13. Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, Van der Sluis LW. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computational Fluid Dynamics model. Int Endod J 2010;43: 874-81.
• Referans14. Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a computational fluid dynamics study. Int Endod J 2009;42:144-55.
• Referans15. Chang JW, Cheung AW, Cheung GS. Effect of root canal dimensions, injection rate, and needle design on the apical extrusion of an irrigant: an in vitro study. JICD 2015;6:221-7.
• Referans16. Gopikrishna V, Sibi S, Archana D, Kumar AR, Narayanan L. An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate. J Conserv Dent 2016;19:189-93.
• Referans17. Zehnder M. Root canal irrigants. J Endod 2006;32:389-98.
• Referans18. Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010;36:875-9.
• Referans19. Silva PB, Krolow AM, Pilownic KJ, Casarin RP, Lima RK, Leonardo RD, Pappen FG. Apical extrusion of debris and irrigants using different irrigation needles. Braz Dent J 2016;27:192-5.
• Referans20. Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 2010; 36:1664-8.
• Referans21. Kalhoro FA, Anwar K, Shaikh MA, Rajput F. Rate of apical extrusion of sodium hypochlorite: open-tip versus closed-tip needles. PODJ 2014;34:159-63.
• Referans22. Psimma Z, Boutsioukis C, Kastrinakis E, Vasiliadis L. Effect of needle insertion depth and root canal curvature on irrigant extrusion ex vivo. J Endod 2013;39:521-4.
• Referans23. Fikirli BS, Altunkaynak B, Kayaoğlu G. Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. AOT 2022;39:58-63.
• Referans24. Chang JW, Cheung AW, Cheung GS. Effect of root canal dimensions, injection rate, and needle design on the apical extrusion of an irrigant: an in vitro study. JICD 2015;6:221-7.
• Referans25. Tinaz AC, Alacam T, Uzun O, Maden M, Kayaoglu G. The effect of disruption of apical constriction on periapical extrusion. J Endod 2005;31:533-5.