KALSİYUM SİLİKA İÇERİKLİ PULPA KAPLAMA MATERYALİNİN IŞIK KAYNAĞININ ÜÇ FARKLI MODU İLE POLİMERİZASYONU ESNASINDA OLUŞAN ISI ARTIŞININ İNCELENMESİ

Öz

Işık ile sertleşen dental materyallerin polimerizasyonu esnasında ortaya çıkan ısı artışı, pulpa hasarına yol açabilmektedir.

Amaç: Bu çalışmanın amacı, 3 farklı polimerizasyon moduna sahip bir LED ışık kaynağının, rezin modifiye kalsiyum silikat içerikli pulpa kaplama ajanının polimerizasyonu esnasında pulpa odasında oluşturduğu ısı değişikliğinin değerlendirilmesidir.

Gereç ve Yöntem: Çekilmiş molar dişin, okluzal yüzeyinde pulpa üzerinde 1 mm kalınlığında dentin tabakası kalacak şekilde düz bir kesim yapıldı. Klinik durumu yansıtmak için, belirli bir basınçla suyun pulpa içerisinde dolaşması sağlanarak pulpal sirkülasyon taklit edildi. Pulpa kaplama materyalinin (TheraCal, Bisco Inc.,USA) ışıkla sertleşmesi esnasındaki ısı artışı ölçüldü. Materyallerin polimerizasyonu için ışık kaynağının üç farklı modu kullanıldı; hızlı polimerizasyon (HP), yavaş artan polimerizasyon (YAP) ve soft polimerizasyon (SP). Oluşan ısısal değişiklikler, bir veri kaydedici ile kaydedildi. Veriler istatiksel olarak tek yönlü ANOVA testi ile değerlendirildi.

Bulgular: ANOVA testi pulpa odasında oluşan ısı değişimlerinin ışık kaynağının farklı modlarından etkilendiğini göstermiştir. Tüm gruplar kendi aralarında istatiksel olarak anlamlı fark göstermiştir (p<0.05). Farklı modlardan kaynaklanan ısı değişimleri şöyledir: HP için (7.19±0.44^°C), YAP için (6.62±0.34°C), SP için (6.10±0.37°C).

Sonuç: Aşağıdaki sonuçlar bulunmuştur; Farklı ışık modlarından kaynaklı intrapulpal ısı değişimleri yüksekten düşüğe doğru şöyle sıralanmaktadır: HP, YAP, SP. Işık kaynağının tüm modları kendi aralarında istatiksel olarak anlamlı fark göstermiştir. TheraCal’in aynı ışık kaynağının farklı modlarıyla polimerizasyonu esnasında 5.5^oC’den fazla intrapulpal ısı artışı gözlenmiştir.

Anahtar Kelimeler

• ışıkla sertleşen dental materyaller, pulpal sirkülasyon, ısı artışı

INVESTIGATION OF TEMPERATURE RISE DURING POLYMERIZATION OF CALCIUM SILICATE CONTAINING PULP-CAPPING MATERIAL WITH DIFFERENT MODES OF LIGHT-CURING UNIT

Öz

Pulp damage may occur because of the temperature rise during polymerization of light-cured dental materials. Aim: The purpose of this study was to evaluate three different curing modes of a light emitting diode (LED) on the temperature rise in the pulp chamber during polymerization of a light-cured resin-modified calcium silicate filled pulp-capping material. Material and Method: A straight-cut was made to the occlusal surface of an extracted molar ensuring 1 mm dentin thickness over the pulp. Pulpal circulation was simulated by water cycling through the pulp chamber with a defined flow pressure to simulate the clinical case. Temperature rise was measured during the light curing of capping material (Theracal, Bisco Inc.,USA). Three modes of light curing unit (Planmeca Lumion,Mectron,Italy) were used to polymerizate the material; fast (FP), slow rise (SRP) and soft (SP). Thermal changes were measured by a data-logger. The data were statistically analyzed by one-way ANOVA. Results: ANOVA test showed that pulp chamber temperature changes were influenced by the mode of light source. All groups showed significant differences between each other (P<0.05). The intrapulpal temperature changes induced by different modes were: (7.19±0.44°C) for FP, (6.62±0.34°C) for SRP, (6.10±0.37°C) for SP. Conclusion: Following conclusions were drawn; The intrapulpal temperature changes induced by various light modes were: FP, SRP and SP in descending order. All curing modes of light curing unit showed significant differences between each other. Light curing of the TheraCal with different polymerization modes of the same light unit resulted in more than 5.5°C increase in the pulp chamber

Anahtar Kelimeler

• Light-cured dental material, pulp circulation, temperature rise

Kaynakça

1. Ozturk B, Usümez A, Oztürk AN, Ozer F. In vitro assessment of temperature change in the pulp chamber during cavity preparation. J Prosthet Dent 2004;9:436–40.
2. Chiodera G, Gastaldi G, Millar BJ. Temperature change in pulp cavity in vitro during the polymerization of provisional resins. Dent Mater 2009;25:321-5.
3. Nomoto R, McCabe JF, Hirano S. Comparison of halogen, plasma and LED curing units. Oper Dent 2004;29:287–94.
4. Hubbezoglu I, Unal M, Zan R, Hurmuzlu F. Temperature rises during application of Er:YAG laser under different primary dentin thicknesses. Photomed Laser Surg 2013;31:201-5.
5. Guiraldo RD, Consani S, Lympius T, Schneider LF, Sinhoreti MA, Correr-Sobrinho L. Influence of the light curing unit and thickness of residual dentin on generation photoactivation. J Oral Sci 2008;50:137-42. during composite
6. Briso ALF, Rahal V, Mestrener SR, Junior RD. Biological response of pulps submitted to different capping materials. Braz Oral Res 2006;20:219-25
7. Pitt Ford TR, Roberts GJ. Immediate and delayed direct pulp capping with the use of a new visible light-cured calcium hydroxide preperation. Oral Surg Oral Med Oral Pat 1991;71:338-42
8. Suh B, Cannon M, Yin R, Martin D. Polymerizable dental pulp healing, capping, and lining material and method for use. International Patent A61K33/42; WO2008US54387 20080220; Publication number WO2008103712 (A2); Publication date 2008.

9. Hubbezoglu I, Dogan A, Dogan OM, Demir H. Kompozit rezin materyallerin farklı ışık kaynaklarıyla polimerizasyonu değişikliklerin incelenmesi. Cumhuriyet Dent J 2008;11:16-22 oluşan ısısal rise polymerization with various light-curing sources. Dent Mater 1999;15:275-81. composite resin
10. Roberts HW, Swift JR, Edward J. Critical appraisal. Pulpal temperature changes during power bleaching procedures. J Esthet Restor Dent 2011; 23:126-31
11. Uhl A, Mills RW, Jandt KD. Polymerization and light-induced heat of dental composite cured with LED and halogen technology. Biomaterials 2003;24:1809-20.
12. Loney RW, Price RBT. Temperature transmission of high-output light-curing units through dentin. Oper Dent 2001;26:516-20.
13. Lloyd CH, Joshi A, McGlynn E. Temperature rises produced by light sources and composites during curing. Dent Mater 1986;2:170–4.
14. Danesh G, Davids H, Duda S, Kaup M, Ott K, Schafer E. Temperature rise in the pulp chamber induced by a conventional halogen light-curing source and a plasma arc lamp. Am J Dent 2004;17:203-8.
15. Bouillaguet S, Caillot G, Forchelet J, Cattani- Lorente M, Wataha JC, Krejci I. Thermal risks from LED and high-intensity QTH-curing units during polymerization of dental resins. J Biomed Mater Res B Appl Biomater 2005;72:260-7.
16. Mills RW, Jandt KD, Ashworth SH. Dental composite depth of cure with halogen and blue light emitting diode technology. Br Dent J 1999;186:388–91
17. Kucukesmen C. Farkli isik kaynaklari ve yeni polimerizasyon teknikleri. Cumhuriyet Dent J 2006;9:126-7
18. Leonard DL, Charlton DG, Roberts HW, Cohen ME. Polymerization efficiency of LED curing lights. J Esthet Restor Dent 2002;14:286-95.
19. Bektas OO, Herguner S, Eren D. Işık kaynaklari, polimerizasyon ve klinik uygulamalar. EU Dis Hek Fak Derg 2006;27:117-124
20. Willershausen B, Ross A, Blettner B. Retrospective study on direct pulp capping with calcium hydroxide. Quintessence Int 2011;42:165-71
21. Baik JW, Rueggeberg FA, Liewehr FR. Effect of light-enhanced bleaching on in vitro surface and intrapulpal temperature rise. J Est Rest Dent 2001;13:370–8
22. Mehrdad L, Malekafzali B, Shekarchi F, Safi Y, Asgary S. Histological and CBCT evaluation of a pulpotomised primary molar using calcium enriched mixture cement. Eur Arch Paediatr Dent 2013;14:191-4
23. Oztürk B, Usümez A, Oztürk AN, Cobanoğlu N. Kalsiyum hidroksit polimerizasyonu esnasında oluşan ısı yükselmesine ışık kaynaklarının etkisi. SU Dis Hek Fak Derg 2011; 20:119-25 rezin materyallerin
24. Rajesh Ebenazar AV, Anilkumar R, Indira R, Ramachandran S, Srinivasan MR. Comparison of temperature rise in the pulp chamber with different light curing units: An in-vitro study. J Conserv Dent 2010;13:132-5
25. Park SH, Roulet JF, Heintze SD. Parameters influencing increase in pulp chamber temperature with light-curing devices: curing lights and pulpal flow rates. Oper Dent 2010;35:353-61
26. Durey K, Santini A, Miletic V. Pulp chamber temperature rise during curing of resin-based composites with different light-curing units. Prim Dent Care 2008;15:33-8
27. Acar Ö, Erkut S. Diş preperasyonu ve pulpal cevap: Literatür derlemesi. Atatürk Üniv Diş Hek Fak Derg 2013;23:282-8
28. Van Hassel AJ. Physiology of the human dental pulp. Oral Surg Oral Med Oral Pathol 1972;32:126- 34
29. Al-Qudah, Mitchell CA, Biagioni PA, Hussey DL. Effect of composite shade, increment thickness and curing light on temperature rise during photocuring. J Dent Res 2007;35:238–45
30. Smail SRJ, Patterson CJW, Mclundie AC, Strang R. In vitro temperature rises during visible-light curing of a lining material and a posterior composite. J Oral Rehabil 1988;15:361-6
31. Ottl P, Lauer HC. Temperature response in the pulpal chamber during ultra-high speed tooth preperation with diamond burs of different grit. J Prosthet Dent 1998;80:12-9
32. Secilmis A, Bulbul M, Sari T, Usumez A. Effects of different dentin thicknesses and air cooling on pulpal temperature rise during laser welding. Lasers Med Sci. 2013;28:167-70.
33. Uzel A, Buyukyilmaz T, Kayalioglu M, Uzel I. Temperature rise during orthodontic bonding with various light-curing units-an in vitro study. Angle Orthod 2006;76:330-4.
34. Deb S, Sehmi H. A comparative study of the properties of dental resin composites polymerized with plasma and halogen light. Dent Mater 2003;19:517–22
35. Mousavinasab SM, Khoroussi M, Moharreri M. Temperature rise during primer, adhesive and composite resin photopolymerization of a low- shrinkage composite resin under caries-like dentin lesions. ISRN Dent 2012;2012:198351.
36. Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA- like material for pulp capping. Int Endod J 2012;45:571-9
37. Zach L, Cohen G. Pulp response to externally applied heat. Oral Surg Oral Med Oral Pat 1965;19:515–30
38. Erikkson A, Albrektsson T, Grane B, McQueen D. Thermal injury to bone. A vital microscopic description of heat effects. Int J Oral Surg 1982;11:115–21
39. Baldissara P, Catapano S, Scotti R. Clinical and histological evaluation of thermal injury thresholds in human teeth: a preliminary study. J Oral Rehabil 1997;24:791–801