Kök Kanal Tedavisinin Yenilenmesine Güncel Bir Bakış

Yıl 2021, Cilt: 12 Sayı: 3, 441 - 450, 25.12.2021

Elif Coşkun Şahin , Berna Kahraman , Kamran Gülşahı

https://doi.org/10.22312/sdusbed.915550

Öz

Kök kanal tedavisinin temel amacı, kök kanal sistemini temizlemek, şekillendirmek ve dişin tekrar enfeksiyonunu önlemek için 3 boyutlu doldurma sağlamaktır. Primer kök kanal tedavisinin başarısız olduğu durumlarda dişin yeniden tedavi edilmesi gerekir. Bu yeniden tedavi, cerrahi yöntemlerden önce endodontik olarak gerçekleştirilebilir. Tedavinin yenilenmesi, aynı hastalığın ilk tedavisinden sonra aynı yöntem veya alternatif bir yöntem ile tedavisi olarak tanımlanır. Kök kanal tedavisi yenilenmesinin başarısı önceki dolgu maddelerinin kök kanallarından tamamen uzaklaştırılmasına, kök kanalların yeniden şekillendirilmesine, temizlenmesine ve doldurulmasına bağlıdır. Uygun yapılmayan kök kanal preparasyonu, kanalların bulunamaması, eksik veya taşkın kök kanal dolgusu, post yerleştirilmesi sırasında yapılan hatalar, yetersiz izolasyon, perforasyonlar, alet kırıkları, dişin doğru restore edilmemesi gibi birçok faktör kök kanal dolgusunun başarısız olmasına sebep olabilir. Artan mekanik zorluklar ve kanaldaki mikrobiyal içeriklerin değişmesi nedeniyle önceki kök kanal tedavisi başarısız olan bir dişin yeniden tedavisi zorlu bir tedavi yaklaşımıdır. Bu sebeple kök kanal tedavisi yenilenmesinin zorlu bir tedavi yaklaşımı olduğu göz ardı edilmemeli, prognoz iyi değerlendirilmeli ve kök kanal tedavisi yenilenmesi uzman kişilerce yapılmalıdır. Günümüzde en sık kullanılan kök kanal dolgu maddesi güta-perkadır. Geçmişte kök kanal tedavisi yenilenmesi sırasında el aletleri ve çözücüler kullanılırken, teknolojinin ilerlemesi ve yeni materyallerin geliştirilmesiyle nikel titanyum döner alet sistemleri ve ilave sistemlerin kullanımı da yaygınlaşmıştır. Kök kanal tedavisi yenilenmesinde kullanılmak üzere özel üretilmiş döner alet sistemleri ve ilave sistemlerden faydalanılarak daha etkili ve hızlı bir tedavi uygulanabilmektedir. Bu makalenin amacı, kök kanal tedavisi yenilenmesi sırasında kullanılan materyalleri gözden geçirmek, döner alet sistemlerinin etkinliklerini incelemek ve güncel kök kanal tedavisi yenileme sistemlerinin etkinlikleri hakkında bilgi vermektedir.

Anahtar Kelimeler

Kanal tedavisinin yenilenmesi, Çözücü, Enfeksiyon, Nikel-titanyum döner alet sistemleri (Ni-Ti)

Teşekkür

Sayın Prof.Dr.Ayşe Gülşahı’ya çalışmamızın her aşamasında yaptığı bilimsel danışmanlık ve katkıları için teşekkür ederiz

A Current Overview of Root Canal Retreatment

Öz

The main purpose of root canal treatment is cleaning and shaping of root canal system and to prevent tooth re-infection by providing 3-dimensional obturation. The tooth must be re-treated in cases which primary root canal treatment was failure. This retreatment can be endodontically performed before surgical procedures. Retreatment is defined as repeating the treatment of the same disease by the same or an alternative method after the first treatment.
The success of retreatment depends on the completely removal of previous filling materials from the root canals, reshaping, cleaning and filling of the canals. Many factors can cause failure of root canal obturation such as inappropriate canal preparation, absence of canals, incmplete or over of root canal filling, making mistakes during placement of post, insufficient isolation, perforations, instrument fractures, and improper restoration of tooth. Because of increasing mechanical difficulties and changing of microbial contents in the canal, retreatment of a tooth which had an unsuccessful previous therapy is a challenging treatment approach. For this reason, challenging of treatment should not be ignored, prognosis should be well evaluated and retreatment should be performed by specialists. Nowadays, the most commonly used root canal filling material is gutta-percha. In the past, hand tools and solvents were used to remove of gutta-percha, but with the advancement of technology and the development of new materials, the use of nickel-titanium rotary file systems and additional systems has become widespread. A more effective and faster treatment prosedure can be applied by using rotary instrument systems and additional systems which specially produced for use in retreatment. The purpose of this article is to review materials used for root canal retreatment, to examine the effectiveness of rotary instrument systems, and to provide information about the effectiveness of current root canal retreatment systems.

Anahtar Kelimeler

Root canal retreatment, Solvent, Infection, Nickel-titanium Rotary File Systems (Ni-Ti)

Kaynakça

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