KÖK KANAL TEDAVİSİ YAPILMIŞ DİŞLERDE FARKLI İRRİGASYON SOLÜSYONLARININ KIRILMA DAYANIMLARI ÜZERİNE ETKİSİNİN İNCELENMESİ

Abstract

Amaç: Farklı irrigasyon solüsyonlarının kök kanal patının dentine bağlanma gücünü olumsuz etkileyebildiğini ve mikroorganizmaların kök kanal sisteminden tamamen uzaklaştırılamadığı görülmüştür. Bu çalışmanın amacı, farklı irrigasyon solüsyonlarının kullanılmasının dişlerin kırılma dayanımları üzerindeki etkisinin değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya 60 adet çürüksüz, tek köklü mandibular premolar diş dahil edildi. Çalışma boyları belirlendi ve kök kanal şekillendirilmesi üretici firmanın talimatlarına göre ProTaper Next (PTN; Dentsply-Sirona) X5 50.06 apikal genişlik elde edilinceye kadar prepare edildi. Ardından, dişler kullanılan irrigasyon solüsyonlarına (Etilendiamin tetraasetik asit (EDTA), Irritrol, Klorheksidin (CHX)) göre rastgele 3 (n=20) gruba ayrıldı. Kırılma dayanım testi uygulandı ve bu kırılma değeri Newton (N) cinsinden kaydedildi. Gruplarda normal dağılım göstermemiştir. Çalışmamızda, Non-Parametrik test olan Kruskall-Wallis ve Mann Whitney U testleri uygulanmıştır. Bulgular: Etilendiamin tetraasetik asit grubu CHX ve Irritrol gruplarına göre daha fazla kırılma dayanımı göstermiştir. Etilendiamin tetraasetik asit ve CHX grupları arasında anlamlı bir farklılık bulunmamıştır (p>0,05). Irritrol ise diğer gruplara göre anlamlı derecede daha düşük kırılma dayanımı göstermiştir (p<0,05). Sonuç: EDTA ve CHX’nin irrigasyon solüsyonu olarak kullanıldıktan sonra kök kanal patına ve gütaperkanın adhezyonuna benzer etkide bulundukları görülmüştür.

Keywords

• Irritrol
• irrigasyon solüsyonu
• kırılma dayanımı
• resin içerikli kök kanal patları

EVALUATING THE EFFECTS OF VARIOUS IRRIGATION SOLUTIONS ON THE FRACTURE STRENGTH OF ENDODONTICALLY TREATED TEETH

Abstract

Objective: Various irrigation solutions can affect the root canal sealer to bind dentine and not remove microorganisms from the root canal system completely. This study’s objective is to investigate the efficiency of fracture strength of various irrigation solution protocols. Material and Methods: The study involves 60 single-rooted teeth. The working lengths were determined, and ProTaper Next (PTN; Dentsply-Sirona) files (X5 50.06) were used to prepare the root canal shaping. The teeth were then randomly divided into three (n=20) groups according to the different irrigation solutions: ethylene diamine tetra acetic acid (EDTA), Irritrol, and chlorhexidine (CHX). A fracture strength test was performed with the fracture value being recorded in Newtons (N). Data were statistically analyzed with the Kruskall-Wallis test (p<0.05). Results: The EDTA group showed higher bond strength values than the CHX or Irritrol groups. No significant difference was found between EDTA and CHX (p>0.05). When using Irritrol as the final irrigation solution, fracture values were significantly lower compared to when CHX and EDTA were used (p<0.05). Conclusion: EDTA and CHX have similar effects on fracture strength.

Keywords

• Fracture strength
• irrigation solutions
• Irritrol
• resin-based sealers

References

1. Donnermeyer D, Vahdat-Pajouh N, Schafer E, Dammaschke T. Influence of the final irrigation solution on the push-out bond strength of calcium silicate-based, epoxy resin-based and silicone-based endodontic sealers. Odontology 2019;107(2):231-6. google scholar
2. Bitter K, Hambarayan A, Neumann K, Blunck U, Sterzenbach G. Various irrigation protocols for final rinse to improve bond strengths of fiber posts inside the root canal. Eur J Oral Sci 2013;121(4):349-54. google scholar
3. Zehnder M. Root canal irrigants. J Endod 2006;32(5):389-98. google scholar
4. Goldsmith M, Gulabivala K, Knowles JC. The effect of sodium hypochlorite irrigant concentration on tooth surface strain. J Endod 2002;28(8):575-9. google scholar
5. Grigoratos D, Knowles J, Ng YL, Gulabivala K. Effect of exposing dentine to sodium hypochlorite and calcium hydroxide on its flexural strength and elastic modulus. Int Endod J 2001;34(2):113-9. google scholar
6. Bozkurt DA, Yusufoglu SI, Keskin NB, Akman M. Effect of activated chlorhexidine and irritrol with photon-induced-photoacoustic-streaming and EDDY® on the dislocation resistance of biodentine. Niger J Clin Pract 2022;25(5):670-6. google scholar
7. Chadha R, Tanea S, Kumar M, Sharma M. An in vitro comparative evaluation of fracture resistance of endodontically treated teeth obturated with different materials. Contemp Clin Dent 2010;1(2):70-2. google scholar
8. Lertchirakarn V, Poonkaew A, Messer H. Fracture resistance of roots filled with gutta-percha or RealSeal®. Int Endod J 2011;44(11):1005-10. google scholar

9. Balkaya H, Topçuoğlu HS, Demirbuga S, Kafdağ Ö, Topçuoğlu G. Effect of different coronal restorations on the fracture resistance of teeth with simulated regenerative endodontic treatment: An in vitro study. Aust Endod J 2022;48(2):331-7. google scholar
10. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974;18(2):269-96. google scholar
11. Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J 2010;43(1):2-15. google scholar
12. Neelakantan P, Sharma S, Shemesh H, Wesselink PR. Influence of Irrigation Sequence on the Adhesion of Root Canal Sealers to Dentin: A Fourier Transform Infrared Spectroscopy and Push-out Bond Strength Analysis. J Endod 2015;41(7):1108-11. google scholar
13. Dogan Buzoglu H, Calt S, Gümüsderelioglu M. Evaluation of the surface free energy on root canal dentine walls treated with chelating agents and NaOCl. Int Endod J 2007;40(1):18-24. google scholar
14. Pane ES, Palamara JE, Messer HH. Critical evaluation of the push-out test for root canal filling materials. J Endod 2013;39(5):669-73. google scholar
15. Wagner MH, da Rosa RA, de Figueiredo JAP, Duarte MAH, Pereira JR, So MVR. Final irrigation protocols may af- fect intraradicular dentin ultrastructure. Clin Oral Investig. 2017;21:2173-82. google scholar
16. Santos JN, Carrilho MR, De Goes MF, Zaia AA, Gomes BP, Souza-Filho FJ, et al. Effect of chemical irrigants on the bond strength of a self-etching adhesive to pulp chamber dentin. J Endod 2006;32(11):1088-90. google scholar
17. Prado M, Santos Jûnior HM, Rezende CM, Pinto AC, Faria RB, Simao RA, et al. Interactions between irrigants commonly used in endodontic practice: a chemical analysis. J Endod 2013;39(4):505-10. google scholar
18. Küçük M, Kermeoğlu F. Efficacy of different irrigation methods on dentinal tubule penetration of Chlorhexidine, QMix and Irritrol: A confocal laser scanning microscopy study. Aust Endod J 2019;45(2):202-8. google scholar
19. Yan W, Montoya C, 0ilo M, Ossa A, Paranjpe A, Zhang H, Arola D. Reduction in Fracture Resistance of the Root with Aging. J Endod 2017;43(9):1494-8. google scholar
20. Ulusoy Öl, Genç Şen Ö, Zeyrek S, Kaya M, Paltun YN. Effect of final irrigation protocols on the fracture resistance of roots with varying dentine thickness. Eur J Oral Sci 2021;129(2):e12769. google scholar
21. Arola D, Reprogel R. Effects of aging on the mechanical behavior of human dentin. Biomaterials. 2005;26(18):4051-61. google scholar
22. Keskin NB, Bozkurt DA, ince Yusufoğlu S. Evaluation of dentinal tubule penetration of Irritrol and chlorhexidine irrigating solutions activated using EDDY and photon-initiated photoacoustic streaming. Photodiagnosis Photodyn Ther 2022;39:102925. google scholar
23. Saricam E, Küçük M, Akyol M. Evaluation of EDTA, QMix, and Irritrol solutions activated with Er,Cr:YSGG and diode lasers on the push-out bond strength of filling material. Microsc Res Tech 2021;84(4):584-91. google scholar