Ultrasonik veya Er,Cr:YSGG lazer ile hazırlanan retrograd kavitelere farklı kendinden pürüzlendirmeli adeziv sistemlerin adaptasyonu

AMAÇ: Apikal cerrahi, kök ucunun kesilmesi, retrograd kavitenin hazırlanması ve bu kavitenin uygun bir materyalle tıkanması gibi aşamaları içeren bir uygulamadır. Bu çalışmanın amacı ultrasonik veya Er,Cr:YSGG lazer ile hazırlanan retrograd kavite yüzeylerine dört farklı adeziv sistemin adaptasyonunun SEM ile incelenmesidir.GEREÇ VE YÖNTEM: Çalışmada 50 adet ön kesici insan dişi kullanıldı. Dişlerin kron kısımları kök boyutları15 mm kalacak şekilde kesilerek uzaklaştırıldıktan sonra kök kanalları ProTaper sistem kullanılarak crown-down tekniği ile şekillendirildi. Takiben dişlerin apikal 3 mm’si fissür uçlu elmas frez ile kökün uzun aksına 90o açı ile kesildi. Kesilen apikal kök yüzeylerine ultrasonik uç veya Er,Cr:YSGG lazer kullanılarak retrograd kaviteler hazırlandı. Daha sonra hem ultrasonik uç hem de Er,Cr:YSGG lazer ile hazırlanan retrograd kaviteler rastgele olarak dört farklı gruba ayrıldı. Her gruba farklı bir adeziv sistem (Clearfil SE Bond, Clearfil Protect Bond, Clearfil S3 Bond ve Optibond SOLO Plus) uygulandı. Takiben ultrasonik uç ve Er,Cr:YSGG lazerin kavite yüzeyinde oluşturduğu smear tabaka ile adeziv sistemlerinretrograd kavite yüzeyinde oluşturdukları hibrit tabaka ve rezin çubuklarının kalitesi tarama elektron mikroskopisi (SEM) ile incelendi.BULGULAR: Çalışmanın sonucunda retrograd kavite yüzeyinde oluşan smear tabakanın özelliklerinin ultrasonik uç ve Er,Cr:YSGG lazer kullanımına göre farklılık gösterdiği gözlendi. Ayrıca adeziv sistemlerin uygulanmasından sonra oluşan hibrit tabakanın kalınlığı, bütünlüğü ve dentin tübülleri içine penetre olma miktarlarının da ultrasonik uç ve Er,Cr:YSGG lazer kullanımına göre değişkenlik gösterdiği saptandı.SONUÇ: Bu çalışma retrograd kaviteyi doldurmak amacıyla kendinden pürüzlendirmeli bir adeziv sistem kullanılacaksa bunun retrograd kavitenin hazırlanma şekli dikkate alınarak seçilmesi gerektiğini göstermektedir.

Anahtar Kelimeler:

Adeziv Sistemler, Apikal Cerrahi, Er Cr:YSGG Lazer, Ultrasonik

Adaptation of different self-etch adhesive systems to retrograde cavities prepared with ultrasound or Er,Cr:YSGG laser

OBJECTIVE: Resection of root end, preparation of a retrocavity and retrofilling with a suitable material are the three basic steps of apicoectomy. The aim of this study was to investigate, with a SEM analysis, the adaptation of four different adhesive systems applied onto ultrasonic or Er:Cr:YSGG laser-treated retrograde cavity surfaces.MATERIALS AND METHOD: Fifty extracted human incisor teeth were used. The teeth were decoronated to a length of15 mm and the canals were prepared using ProTaper system with a crown-down technique. The apical3 mm was cut perpendicular to the long axis of the root using a fissure bur. Retrograde cavities were prepared using ultrasonic tip or Er,Cr:YSGG laser on the exposed root surfaces. Root specimens of the ultrasonic or laser groups were randomly divided to four groups. One of four adhesive systems were applied in each group (Clearfil SE Bond, Clearfill Protect Bond, Clearfill S3 Bond or Optibond SOLO Plus). Smear layer produced on the root surface after ultrasound or laser, and the quality of the hybrid layer and resin tags that have formed after application of the adhesives were examined under SEM.RESULTS: Characteristics of the smear layer formed after the use of ultrasonic or laser were different. The thickness and integrity of the hybrid layer and penetration into dentinal tubules of the adhesives were also found to differ depending on the use of ultrasound or laser.CONCLUSION: The findings of the study suggest that the selfetch adhesive system be selected according to the retrocavity preparetion technique used.

Keywords:

Adhesive Systems, Apical Surgery, Er Cr:YSGG Laser, Ultrasonics,

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