Epoksi Rezin İçerikli Bir Patın NaOCl ile Tedavi Edilmiş Kök Kanallarına Adezyonunda Antioksidan Ajanların Etkisi

Öz

Amaç: Endodontide geleneksel irrigasyon solüsyonu olarak sodyum hipoklorit NaOCl kullanımı rezin içerikli materyallerin dentine adeziv bağlanmasını zayıflatabilmektedir fakat; bu olumsuz etki antioksidan ajanlarla geriye döndürülebilmektedir. Çalışmada; NaOCl ile tedavi edilmiş dentine rezin esaslı bir kök kanal patının bağlanma dayanımını artırmada antioksidan ajanların etkisi değerlendirilmiştir. Gereç ve Yöntemler: 38 adet alt mandibular premolar diş kök kanalı distile su irrigasyonu altında resiprokal sistem kullanılarak şekillendirilmiştir. Şekillendirme sonrası kök kanalları 4 gruba ayrılmış n=8 ve takip eden irrigasyon rejimleri uygulanmıştır: 1 %5 sodyum hipoklorit NaOCl 10 dk/ %17 etilen diamin tetraasetik asit EDTA 1 dk; 2 %5 NaOCl / %30 üzüm çekirdeği özütü GSE / %17 EDTA; 3 %5 NaOCl / %10 askorbik asit AA / %17 EDTA; 4 distile su 10 dk kontrol grubu . İrrigasyon prosedürleri tamamlandıktan sonra kanallar kanal patı ve güta perka ile dolduruldu. Örnekler; 7 gün boyunca 37 °C’de bir inkübatörde bekletildikten sonra bağlanma dayanımı testi uygulandı. Kalan 6 dişe solüsyonların grup ve tek irrigasyon protokolleri uygulandı ve SEM görüntüleri elde edildi. Bulgular: Üçlü bölgelerine göre bağlanma dayanımı değerlendirildiğinde; Grup 2 ile diğer gruplar arasında anlamlı istatistiksel farklılık gözlendi. Grup 2 her üçlü bölgesinde de en yüksek bağlanma dayanımı değerlerini gösterdi. Sonuç: Çalışmanın limitasyonları dahilinde; %30 GSE NaOCl’nin olumsuz etkilerini ortadan kaldırmak için kanal içi final irrigasyonda alternatif bir antioksidan olarak kullanılabilir

Anahtar Kelimeler

• Antioksidan ajanlar, Rezin siman, Askorbik asit

The Effect of Antioxidant Agents on Adhesion of an Epoxy Resin Based Sealer to NaOCl-Treated Root Dentin

Abstract

Objective: The use of sodium hypochlorite NaOCl as a traditional endodontic irrigant lowers the bond strength of resin based materials to dentine but this can be reversed by the use of antioxidant agents. The aim of this study was to evaluate the effect of antioxidant agents in improving the bond strength of a resin based sealer to NaOCl-treated root dentin.Material and Methods: Thirty eight mandibular premolar root canals were shaped using reciprocating fıles with distilled water and four groups n=8 were conditioned with one of the following irrigation regimens: 1 5% sodium hypochlorite NaOCl for 10 minutes and then 17% EDTA for 1 min; 2 5% NaOCl for 10 minutes followed by 30% grape seed extract GSE for 10 minutes and then 17% EDTA for 1 min; 3 5% NaOCl for 10 minutes followed by 10% ascorbic acid for 10 minutes and 17% EDTA for 1 minute; 4 distilled water for 10 minutes control . After the irrigation procedures, all roots were filled with sealer and gutta percha. Samples were placed in an incubator at 37 °C for 7 days and then the push-out bond strength test was performed. Group and single irrigation protocols of the solutions were applied to the remaining 6 teeth and SEM images were obtained.Results: There were statistically significant differences between the values for the root thirds in Group 2 and the other groups. Group 2 achieved the highest bond strength among all groups in each root third. Conclusion: 30% grape seed extract can be an alternative antioxidant agent for the final irrigation protocol to reverse the negative effect of NaOCl

Keywords

• Antioxidant agents, Resin cement, Ascorbic acid

Kaynakça

1. Sundqvist G, Figdor D, Persson S, Sjögren 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(1):86-93.
2. DeLong C, He J, Woodmansey KF. The effect of obturation technique on the push-out bond strength of calcium silicate sealers. J Endod 2015; 41(3):385-8.
3. Siqueira JF Jr, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod 2000; 26(6):331-4.
4. Paqué F, Balmer M, Attin T, Peters OA. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: A micro-computed tomography study. J Endod 2010; 36(4):703-7.
5. Dalton BC, Orstavik D, Phillips C, Pettiette M, Trope M. Bacterial reduction with nickel-titanium rotary instrumentation. J Endod 1998; 24(11):763-7.
6. Prasansuttiporn T, Nakajima M, Kunawarote S, Foxton RM, Tagami J. Effect of reducing agents on bond strength to NaOCl-treated dentin. Dent Mater 2011; 27(3):229- 34.
7. Han B, Jaurequi J, Tang BW, Nimni ME. Proanthocyanidin: A natural crosslinking reagent for stabilizing collagen matrices. J Biomed Mater Res A 2003; 65(1):118-24.
8. Bedran-Russo AK, Castellan CS, Shinohara MS, Hassan L, Antunes A. Characterization of biomodified dentin matrices for potential preventive and reparative therapies. Acta Biomater 2011; 7:1735-41.

9. Manimaran VS, Srinivasulu S, Rajesh Ebenezar A, Mahalaxmi S, Srinivasan N. Application of a proanthocyanidin agent to improve the bond strength of root dentin treated with sodium hypochlorite. J Conserv Dent 2011; 4(3):306-8.
10. Kalra M, Iqbal K, Nitisusanta LI, Daood U, Sum CP, Fawzy AS. The effect of proanthocyanidins on the bond strength and durability of resin sealer to root dentine. Int Endod J 2013; 46(2):169-78.
11. Nagpal R, Manuja N, Pandit IK. Effect of proanthocyanidin treatment on the bonding effectiveness of adhesive restorations in pulp chamber. J Clin Pediatr Dent 2013; 38(1):49-53.
12. Cecchin D, Pin LC, Farina AP, Souza M, Vidal Cde M, Bello YD, Ferraz CC, Bedran-Russo A. Bond strength between fiber posts and root dentin treated with natural cross-linkers. J Endod 2015; 41(10):1667-71.
13. Vongphan N, Senawongse P, Somsiri W, Harnirattisai C. Effects of sodium ascorbate on microtensile bond strength of total-etching adhesive system to NaOCl treated dentine. J Dent 2005; 33(8):689-95.
14. Barutcigil C, Harorli OT, Ozcan E, Arslan H, Yildiz M. Effects of ethylenediaminetetraacetic acid and sodium hypochlorite on the bond strength of bonding agents to pulp chamber lateral walls. JDS 2014;9(3): 229-34.
15. Ari H, Yasar E, Belli S. Effects of NaOCl on bond strengths of resin cements to root canal dentin. J Endod 2003;29: 248-51.
16. Tuncay Ö. Farklı Dezenfeksiyon Yöntemlerinin Rezin Esaslı Kanal Dolgu Patlarının Adezyonu ve Yüzey Sertliği Üzerine Etkisi. Doktora Tezi. Kayseri: Erciyes Üniversitesi, 2014.
17. Shrestha D, Wu WC, He QY, Wei X, Ling JQ. Effect of sodium ascorbate on degree of conversion and bond strength of RealSeal SE to sodium hypochlorite treated root dentin. Dent Mater 2013; 32(1):96-100.
18. Stelzer R, Schaller HG, Gernhardt CR. Push-out bond strength of RealSeal SE and AH Plus after using different irrigation solutions. J Endod 2014; 40(10):1654-7.
19. Kok D, Rosa RA, Barreto MS, Busanello FH, Santini MF, Pereira JR, Só MV. Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: A confocal laser scanning microscopy study. Microsc Res Tech 2014; 77(6):467-71.
20. Bors W, Heller W, Michel C, Saran M. Flavonoids as antioxidants: Determination of radical-scavenging efficiencies. Methods Enzymol 1990; 186:343-55.