Son yıkamada kullanılan %5 ve %17 EDTA çözeltilerinin smear tabaka ve debriz uzaklaştırma etkinliklerinin ve dentin mikrosertliğine etkilerinin karşılaştırılması: in vitro çalışma

Yıl 2016, , 63 - 8, 04.05.2016

Gizem Demiray Kökçü Ahmet Güral Bülent Altunkaynak Güven Kayaoğlu

https://doi.org/10.17214/aot.33915

Öz

AMAÇ: Bu in vitro çalışmanın amacı, %5 ve %17 etilendiamintetraasetik asit (EDTA) çözeltilerinin son yıkama çözeltisi olarak kullanıldıklarında, smear tabaka ve debris uzaklaştırma etkinliklerinin ve dentin mikrosertliği üzerine etkilerinin karşılaştırılmasıydı.

GEREÇ VE YÖNTEM: Yetmiş adet çekilmiş, tek köklü, insan alt çene, küçük azı dişi endodontik olarak enstrümante edildi ve son yıkamaya göre 4 gruba dağıtıldı: G1: 17% EDTA + 2.6% NaOCl (sırasıyla, 3 dak. ve 1 dak. uygulandı), G2: 5% EDTA + 2.6% NaOCl, G3 (kontrol): salin + 2.6% NaOCl, and G4 (kontrol): salin. G1-G3 gruplarına ait dişler boylamasına ikiye ayrıldı ve smear ve debriz incelemesi için, apeksten 2 ve 6 mm mesafelerde tarama elektron mikrografları elde edildi. Ayrıca, tüm gruplardaki dişler horizontal olarak kesilerek, kanal boşluğundan 500, 1000 ve 1500 µm mesafelerde Vickers mikrosertlik ölçümleri yapıldı. Veri p<0.05 seviyesinde istatistiksel olarak incelendi.

BULGULAR: Smear tabakası için ölçüm değerleri, her iki EDTA grubunda da 2 mm seviyesinde, 6 mm seviyesine göre anlamlı olarak daha yüksekti; EDTA grupları arasında herbir seviye için anlamlı fark yoktu. Kontrole göre, 2 mm seviyesinde, %17 EDTA grubunda anlamlı olarak daha az smear tabakası vardı. Dentin mikrosertliği bakımından, gruplar arasında istatistiksel olarak farklılık yalnızca 1500 µm mesafede görüldü; burada %17 EDTA grubu en düşük mikrosertlik değerlerini sergiledi.

SONUÇ: Enstrümante kök kanalı yüzeyinden smear tabakası ve debris uzaklaştırma bakımından %5 ve %17 EDTA çözeltileri benzer etkinlik gösterdi. Ancak, %5 EDTA çözeltisi dentin mikrosertliğini %17 EDTA çözeltisi gibi azaltmadı.

Anahtar Kelimeler

anizotropi, kelat edici ajanlar, endodonti, kök kanalı sulayıcıları, kök kanal tedavisi

Comparison of the smear layer- and debris-removal abilities and the effects on dentinal microhardness of 5% and 17% EDTA solutions used as final irrigants: in vitro study

Öz

OBJECTIVE: The aim of this in vitro study was to evaluate the effects on dentinal microhardness, and the smear layer- and debris-removal properties, of 5% and 17% ethylenediaminetetraacetic acid (EDTA) solutions when used as final irrigants.

MATERIALS AND METHOD: Seventy extracted single-root human mandibular premolars were endodontically instrumented and distributed into 4 groups, according to the final irrigant: G1: 17% EDTA + 2.6% NaOCl (applied for 3 min and 1 min, respectively), G2: 5% EDTA + 2.6% NaOCl, G3 (control): saline + 2.6% NaOCl, and G4 (control): saline. Teeth from G1–G3 were split longitudinally, and scanning electron micrographs were obtained at 2 and 6 mm from the apex for smear layer and debris analyses. Teeth in all groups were sectioned horizontally, and Vickers microhardness values were measured at 500, 1000, and 1500 µm from the canal lumen. Data were statistically analyzed at the p<0.05 level.

RESULTS: Smear layer scores were significantly greater at the 2-mm vs the 6-mm level in both EDTA groups, with no significant difference between EDTA groups at either level. Significantly less smear layer was found in the 17% EDTA group compared to the control at the 2-mm level. A statistically significant difference in microhardness among groups was found only at the 1500-µm level, with the 17% EDTA group exhibiting the lowest microhardness values.

CONCLUSION: The 5% and 17% EDTA solutions were equally effective at removing the smear layer and debris from instrumented root canal surfaces. However, the 5% EDTA solution did not decrease the microhardness of dentin like 17% EDTA.

Anahtar Kelimeler

Anisotropy, chelating agents, endodontics, root canal irrigants, root canal therapy

Kaynakça

• Nakashima K, Terata R. Effect of pH modified EDTA solution to the properties of dentin. J Endod 2005;31:47-9. Erratum in: J Endod. 2005;31:477.
• Aslantas EE, Buzoglu HD, Altundasar E, Serper A. Effect of EDTA, sodium hypochlorite, and chlorhexidine gluconate with or without surface modifiers on dentin microhardness. J Endod 2014;40:876-9.
• Cruz-Filho AM, Sousa-Neto MD, Savioli RN, Silva RG, Vansan LP, Pécora JD. Effect of chelating solutions on the microhardness of root canal lumen dentin. J Endod 2011;37:358-62.
• Ghisi AC, Kopper PM, Baldasso FE, Stürmer CP, Rossi-Fedele G, Steier L, et al. Effect of super-oxidized water, sodium hypochlorite and EDTA on dentin microhardness. Braz Dent J 2014;25:420-4.
• Ryou H, Amin N, Ross A, Eidelman N, Wang DH, Romberg E, et al. Contributions of microstructure and chemical composition to the mechanical properties of dentin. J Mater Sci Mater Med 2011;22:1127-35.
• Pashley D, Okabe A, Parham P. The relationship between dentin microhardness and tubule density. Endod Dent Traumatol 1985;1:176-9.
• Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivator system, the F file, ultrasonic irrigation, and NaOCl irrigation alone after hand-rotary instrumentation in human mandibular molars. J Endod 2010;36:1367-71.
• Gambarini G, Laszkiewicz J. A scanning electron microscopic study of debris and smear layer remaining following use of GT rotary instruments. Int Endod J 2002;35:422-7.
• Hata G, Hayami S, Weine FS, Toda T. Effectiveness of oxidative potential water as a root canal irrigant. Int Endod J 2001;34:308-17.
• Kaya S, Yiğit-Özer S, Adigüzel Ö. Evaluation of radicular dentin erosion and smear layer removal capacity of Self-Adjusting File using different concentrations of sodium hypochlorite as an initial irrigant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:524-30.
• Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysis. Int Endod J 2005;38:285-90.
• Ballal NV, Mala K, Bhat KS. Evaluation of the effect of maleic acid and ethylenediaminetetraacetic acid on the microhardness and surface roughness of human root canal dentin. J Endod 2010;36:1385-8.
• Dai L, Khechen K, Khan S, Gillen B, Loushine BA, Wimmer CE, et al. The effect of QMix, an experimental antibacterial root canal irrigant, on removal of canal wall smear layer and debris. J Endod 2011;37:80-4.
• Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
• Slutzky-Goldberg I, Maree M, Liberman R, Heling I. Effect of sodium hypochlorite on dentin microhardness. J Endod 2004;30:880-2.
• Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007;33:472-5.
• Akcay I, Sen BH. The effect of surfactant addition to EDTA on microhardness of root dentin. J Endod 2012;38:704-7.
• Kuçi A, Alaçam T, Yavaş O, Ergul-Ulger Z, Kayaoglu G. Sealer penetration into dentinal tubules in the presence or absence of smear layer: a confocal laser scanning microscopic study. J Endod 2014;40:1627-31.
• Daghustani M, Alhammadi A, Merdad K, Ohlin J, Erhardt F, Ahlquist M. Comparison between high concentration EDTA (24%) and low concentration EDTA (3%) with surfactant upon removal of smear layer after rotary instrumentation: a SEM study. Swed Dent J 2011;35:9-15.
• Sen BH, Ertürk O, Pişkin B. The effect of different concentrations of EDTA on instrumented root canal walls. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:622-7.
• Garberoglio R, Becce C. Smear layer removal by root canal irrigants. A comparative scanning electron microscopic study. Oral Surg Oral Med Oral Pathol 1994;78:359-67.
• Fuentes V, Ceballos L, Osorio R, Toledano M, Carvalho RM, Pashley DH. Tensile strength and microhardness of treated human dentin. Dent Mater 2004;20:522-9.
• Sayin TC, Serper A, Cehreli ZC, Otlu HG. The effect of EDTA, EGTA, EDTAC, and tetracycline-HCl with and without subsequent NaOCl treatment on the microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:418-24.
• Ulusoy Öİ, Görgül G. Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. Aust Endod J 2013;39:66-72.
• Eldeniz AU, Erdemir A, Belli S. Effect of EDTA and citric acid solutions on the microhardness and the roughness of human root canal dentin. J Endod 2005;31:107-10.
• Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J 2010;43:2-15.
• Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:658-66.
• Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am 2010;54:291-312.