Endodonti-Ortodonti Arayüzü: Kök Rezorpsiyonu ve Hasta Yönetimi ilişkisi

Yıl 2023, Cilt: 9 Sayı: 1, 11 - 18, 14.04.2023

Büşra Demir Çiçek , Orhan Çiçek

https://doi.org/10.21306/dishekimligi.1187571

Öz

Endodontik tedaviler ortodontik tedavi için bir kontrendikasyon oluşturmadığı için endodontik tedavi görmüş dişler ortodontik olarak hareket ettirilebilir. Bununla birlikte, endodontik ve ortodontik tedaviler arasındaki kesin ilişki hakkında literatürde veri eksikliği mevcut olup, bu ilişki ortodontik tedavinin pulpa ve periyodonsiyumda neden olduğu çeşitli etkilerden oluşur. Kök kanal dolgu materyalinin periapikal dokularda çok az ya da hiç irritasyona neden olmayacak şekilde tamamen kanal içinde olduğu durumlarda periapikal ve/veya pulpa lezyonu hemen iyileşmeye başlar. Apikal periyodontal onarım bu iyileşme sonrası başlamakla birlikte, kök kanalı sızıntısı veya rezin, silikon, çinko oksit öjenol, biyoseramik veya güta-perka gibi kök kanal dolgu materyallerinin periapikal bölgede kalması durumunda yabancı cisim granülomlarının oluşması tetiklenir. Bu granülomlar diş hareketini engellemese de, üç ayda bir periapikal radyografilerle konumları kontrol edilmeli ve daimi kanal dolgusunun da ortodontik tedavi tamamlanana kadar ertelenmesiyle psödo aşırı doldurma önlenebilir. Bu nedenle, pulpa hasarını kısıtlamak ve hatta iyileşmesine yardımcı olmak amacıyla istenen diş hareketini sağlayacak optimal kuvvet uygulanması önerilir. Ayrıca, ortodontik tedaviden önce endodontik tedavili dişlerin hem klinik hem de radyografik olarak periapikal durumunun kapsamlı değerlendirilmesi önemlidir. Bu derlemede, endodontik ve ortodontik tedavilerde kök rezorpsiyonu etkisi, tedavi planlamasında dikkat edilmesi gerekenler ve hasta yönetimi hakkında güncel bilimsel kanıtlar gözden geçirilerek konu hakkında bilgi düzeyinin arttırılması amaçlanmıştır.

Anahtar Kelimeler

Endodontik tedavi, ortodontik diş hareketi, kök rezorpsiyonu, tedavi planlaması, hasta yönetimi

Endodontics-Orthodontics Interface: Root Resorption and Patient Management Relationship

Öz

Since endodontic treatments do not constitute a contraindication for orthodontic treatment, endodontically treated teeth can be moved orthodontically. However, there is a lack of data in the literature on the precise relationship between endodontic and orthodontic treatments, and this relationship consists of various effects of orthodontic treatment on the pulp and periodontium. In cases where the root canal filling material is completely inside the canal with little or no irritation to the periapical tissues, the periapical and/or pulpal lesion begins to resolve immediately. Although apical periodontal repair begins after this resolving, foreign body granulomas are triggered when root canal leakage or root canal filling materials such as resin, silicon, zinc oxide eugenol, bioceramic or gutta-percha remain in the periapical region. Although these granulomas do not prevent tooth movement, their position should be controlled with periapical radiographs every three months and pseudo-overfilling can be prevented by delaying permanent canal filling until orthodontic treatment is complete. Therefore, it is recommended to apply optimal force to provide desired tooth movement in order to limit pulp damage and even aid resolving. In addition, comprehensive evaluation of the periapical conditions of endodontically treated teeth, both clinically and radiographically, is important before orthodontic treatment. In this review, it is aimed to increase the level of knowledge on this issue by reviewing the current scientific evidence about the effect of endodontic and orthodontic treatments on root resorption, considerations in treatment planning and patient management.

Anahtar Kelimeler

Endodontic treatment, orthodontic tooth movement, root resorption, treatment planning, patient management

Kaynakça

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