NİKEL TİTANYUM EĞELERİN TEKRARLAYAN KÖK KANAL TEDAVİSİ SIRASINDA APİKAL DEBRİS TAŞKINLIĞININ KARŞILAŞTIRILMASI

Yıl 2023, , 19 - 25, 14.04.2023

İsmail Konyalı , Mustafa Murat Koçak , Baran Can Sağlam , Sibel Tazegül-kocak

https://doi.org/10.21306/dishekimligi.1239206

Öz

Amaç: Bu çalışmanın amacı, 5 farklı eğe sisteminin alt çene azı dişlerinde tekralayan kök kanal tedavisi uygulaması sırasında kök kanallarından taşan doku ve dolgu materyali miktarları üzerindeki etkilerini karşılaştırarak değerlendirilmesidir.
Gereç ve Yöntemler: Çalışmamızda 80 adet çekilmiş alt çene büyükazı dişine ait mezial kökler kullanıldı. Köklerin çalışma uzunluğu belirlenmesinin ardından şekillendirme prosedürü ProTaper Universal F2 nolu eğe ile tamamlandıktan sonra kanallar lateral kondenzasyon ile dolduruldu. Kanal tedavisi yenileme işleminde ProTaper Next, TF Adaptive, Endoart, WaveOne Gold ve ProTaper Universal Retreatment eğeleriyle olacak şekilde rastgele beş gruba ayrılarak kanal sökümü yapıldı. Taşan debris miktarı boş ağırlığı önceden ölçülmüş olan Eppendorf tüplerinde biriktirildi. Taşan debris miktarı tüm işlemler sonrası ölçüldü.
Bulgular: Her deney gruplarının tamamında kök dışına madde çıkışı gözlendi. İstatistiksel analiz sonucunda ProTaper Next ve ProTaper Universal Retreatment anlamlı olarak TF Adaptive daha az taşkınlığa neden olduğu tespit edildi (p<0,05). Diğer gruplar arasında anlamlı bir fark bulunmadı (p>0,05). Tüm gruplar incelendiğinde en fazla materyal taşkınlığı WaveOne Gold grubunda görüldü.
Sonuç: Bu çalışmada elde edilen bulgular değerlendirildiğinde, yeni üretilen bu eğe sistemi için, güncel ve yaygın olarak kullanılan eğeler ile elde edilen bulgular ile karşılaştırıldığında umut verici bir sonuç olarak değerlendirilebilir. Ancak, bu sistemin klinik performansının değerlendirilmesi için çok sayıda farklı araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

endodonti, kanal tedavisi, nikel titanyum eğe, tekrarlayan tedavi, apikal ekstrüzyon

COMPARISON OF APICAL DEBRIS EXTRUSION OF DIFFERENT NICKEL TITANIUM FILES DURING RETREATMENT

Öz

Objective: The aim of this study is to compare and evaluate the effects of 5 different file systems on the amount of tissue and filling material overflowing from the root canals during retreatment of mandibular molars.
Methods: In our study, mesial roots of 80 extracted mandibular molars were used. After the working length was determined, the shaping procedure was completed with the ProTaper Universal F2 file, and the canals were filled with lateral condensation. Root canal removal was performed randomly in five groups, using ProTaper Next, TF Adaptive, Endoart, WaveOne Gold, and ProTaper Universal Retreatment files for root canal retreatment. The amount of extruded debris was collected in Eppendorf tubes with pre-measured empty weight. The amount of extruded debris was weighed after all instrumentation procedures.
Results: Out of root matter was observed in all of the experimental groups. As a result of the statistical analysis, it was determined that ProTaper Next and ProTaper Universal Retreatment caused significantly less outflow than TF Adaptive (p<0.05). There was no significant difference between the other groups (p>0.05). When all groups were examined, the most material overflow was seen in the WaveOne Gold group.
Conclusion: When the findings obtained in this study are evaluated, it can be considered as a promising result for this newly produced file system when compared with the findings obtained with current and widely used files. However, many different studies are needed to evaluate the clinical performance of this system.

Anahtar Kelimeler

endodontics, root canal treatment, nickel titanium instrument, retreatment, apical extrusion

Kaynakça

• 1. Webber J, Machtou P, Pertot W, Kuttler S, Ruddle C, West J. The WaveOne single-file reciprocating system. Roots. 2011;1(1):28-33.
• 2. Sjögren U, Hägglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16(10):498-504.
• 3. Lovdahl PE. Endodontic retreatment. Dent Clin North Am. 1992;36(2):473-90.
• 4. Somma F, Cammarota G, Plotino G, Grande NM, Pameijer CH. The effectiveness of manual and mechanical instrumentation for the retreatment of three different root canal filling materials. J Endod. 2008;34(4):466-9.
• 5. Song M, Chung W, Lee S-J, Kim E. Long-term outcome of the cases classified as successes based on short-term follow-up in endodontic microsurgery. J Endod. 2012;38(9):1192-6.
• 6. Bürklein S, Schäfer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod. 2012;38(6):850-2.
• 7. Toyoğlu M, Altunbaş DJ. Influence of different kinematics on apical extrusion of irrigant and debris during canal preparation using K3XF instruments. J Endod. 2017;43(9):1565-8.
• 8. Glassman G, Gambarini G, Rosler S. Twisted Files and Adaptive Motion Technology: A Winning Combination for Safe and Predictable Root Canal Shaping. Roots. 2016;3(1):14-20.
• 9. Ertaş H, Çapar İd, Arslan H. Cyclic fatigue resistance of protaper universal, twisted file adaptive, reciproc and waveone systems. Turk Endod J. 2016;1(1):30–4.
• 10. Çitak M, Özyürek T. Effect of different nickel-titanium rotary files on dentinal crack formation during retreatment procedure. J Dent Res Dent Clin Dent Prospects. 2017;11(2):90-5.
• 11. Özyürek T, Demiryürek EÖ. Efficacy of different nickel-titanium instruments in removing gutta-percha during root canal retreatment. J Endod. 2016;42(4):646-9.
• 12. Martins MP, Duarte MA, Cavenago BC, Kato AS, da Silveira Bueno CE. Effectiveness of the ProTaper Next and Reciproc Systems in Removing Root Canal Filling Material with Sonic or Ultrasonic Irrigation: A Micro-computed Tomographic Study. J Endod. 2017;43(3):467-471.
• 13. Ruddle CJ. Single-File Shaping Technique: Achieving a Gold Medal Result. Dent Today. 2016;35(1):98, 100, 102-3.
• 14. http://www.incidental.com.tr/urunler/endoart-touch-gold. 2022
• 15. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275-9.
• 16. Friedman S, Mor C. The success of endodontic therapy-healing and functionality. J Calif Dent Assoc. 2004;32(6):493-503.
• 17. Khedmat S, Azari A, Shamshiri AR, Fadae M, Bashizadeh Fakhar H. Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals. Iran Endod J. 2016;11(3):184-7.
• 18. Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: a meta-analysis of literature. J Endod. 2008;34(10):1177-81.
• 19. Ruiz-Hubard EE, Gutmann JL, Wagner MJ. A quantitative assessment of canal debris forced periapically during root canal instrumentation using two different techniques. J Endod. 1987;13(12):554-8.
• 20. Azar NG, Ebrahimi G. Apically‐extruded debris using the ProTaper system. Aust Endod J. 2005;31(1):21-3.
• 21. Leonardi LE, Atlas DM, Raiden G. Apical extrusion of debris by manual and mechanical instrumentation. Braz Dent J. 2007;18(1):16-9.
• 22. Al-Omari MA, Dummer PM. Canal blockage and debris extrusion with eight preparation techniques. J Endod. 1995;21(3):154-8.
• 23. Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod. 2015;41(2):237-41.
• 24. Sen OG, Bilgin B, Koçak S, Sağlam BC, Koçak MM. Evaluation of apically extruded debris using continuous rotation, reciprocation, or adaptive motion. Braz. Dent. J. 2018;29(3):245-8.
• 25. Karataş E, Arslan H, Kırıcı D, Alsancak M, Çapar I. Quantitative evaluation of apically extruded debris with Twisted File Adaptive instruments in straight root canals: reciprocation with different angles, adaptive motion and continuous rotation. Int Endod J. 2016;49(4):382-5.
• 26. Nevares G, Romeiro K, Albuquerque D, Xavier F, Fogel H, Freire L, et al. Evaluation of apically extruded debris during root canal retreatment using ProTaper Next and Reciproc in severely curved canals. Iran Endod J. 2017;12(3):323.
• 27. Yılmaz K, Özyürek T. Apically extruded debris after retreatment procedure with Reciproc, ProTaper Next, and Twisted File Adaptive instruments. J Endod. 2017;43(4):648-51.
• 28. Silva EJ, Sa L, Belladonna FG, Neves AA, Accorsi-Mendonca T, Vieira VT, et al. Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod. 2014;40(12):2077-80.
• 29. Bürklein S, Benten S, Schäfer E. Quantitative evaluation of apically extruded debris with different single‐file systems: R eciproc, F 360 and O ne S hape versus M two. Int Endod J. 2014;47(5):405-9.
• 30. De-Deus G, Neves A, Silva EJ, Mendonca TA, Lourenco C, Calixto C, et al. Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig. 2015;19(2):357-61.
• 31. Keskin NB, Güneç G. Comparison of Cyclic Fatigue Resistance of Heat-Treated Nickel-Titanium Reciprocating Instruments at the Intracanal Temperature. Balkan Journal of Dental Medicine.25(2):87-91.
• 32. Güçyetmez Topal B, Falakaloğlu S, Türkoğlu H. Comparison of Shaping Ability between Continuous Rotary and Manual Instrumentations in Pediatric Endodontics. J. Dent. Indones. 2021;28(2):70-5.