Dilara ARSLAN, Mehmet Burak GÜNEŞER, Fatma KAPLAN, Aslıhan ÜŞÜMEZ

FARKLI RETROGRAD KAVİTE AÇMA TEKNİKLERİNİN VE RETROGRAD DOLGU BİODENTİNİN APİKAL SIZINTI ÜZERİNE ETKİSİ

Amaç: Erbium:Yttrium Aluminium Garnet (Er:YAG) ve Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) lazer kullanılarak hazırlanmış retrograd kavitelerde Biodentin dolgu materyeli kullanımının apikal sızıntı üzerine etkisinin boya penetrasyon testi kullanılarak incelenmesidir. Gereç ve yöntem: Kuronları uzaklaştırılan 64 adet tek köklü çekilmiş insan dişi ProTaper eğe sistemi ile F4’e kadar ile şekillendirildi. Guta-perka ve AH plus kanal patı kullanılarak lateral kondensasyon yöntemi ile dolduruldu. Apikal 3 mm’ lik parçalar kökün uzun aksına 90° olacak şekilde kesilerek uzaklaştırıldı. Kökler rastgele 8 gruba ayrıldı. (n:8); Grup 1: Hiçbir işlem yapılmadı, Grup 2: Apikal kök yüzeyine Nd:YAG lazer uygulandı, Grup 3: Fissür frez ile Sınıf 1 kavite açıldı (KP), Grup 4: Fissür frez ile KP+Biodentin, Grup 5: Fissür frez ile KP+Nd:YAG lazer+Biodentin, Grup 6: Er:YAG lazer ile KP, Grup 7: Er:YAG lazer ile KP+Biodentin, Grup 8: Er:YAG lazer ile KP+Nd:YAG lazer+ Biodentin. Kök yüzeyleri apikal 1mm hariç iki kat tırnak cilası kaplandı ve 15 gün süre ile çini mürekkebinde bekletildi. Apikal sızıntı şeffaflaştırma yöntemi ile değerlendirildi. İstatistiksel analiz Mann-Whitney U ve Kruskal-Wallis testleri kullanılarak yapıldı. Bulgular: Biodentin ile doldurulmuş gruplar (4,5,7,8) arasında boya sızıntısı açısından istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0.05). Biodentin uygulanan tüm gruplar ile (4,5,7,8) uygulanmayan diğer tüm gruplar (1,2,3,6) arasında istatistiksel olarak anlamlı fark tespit edilmiştir (p<0.05). Kavite açılımı olmadan apisektomi sonrası Nd:YAG lazer uygulanan grup 2 ile diğer tüm arasında istatistiksel olarak anlamlı fark elde edilmiştir (p<0.05). Sonuç: Uygulanan kavite açım prosedürlerinin farklılığına bakılmaksızın, Biodentin apikal szınıtıyı engellemiştir. Apisektomi sonrası Nd: YAG lazer uygulaması hiçbir işlem uygulanmamasına alternatif olarak önerilebilir. Anahtar Kelimeler: Biodentine, Er: YAG lazer, Nd: YAG lazer, retrograd tıkama THE EFFECT OF VARIOUS RETROCAVITY PREPARATION TECHNIQUES AND RETROFILLING WITH BIODENTINE ON APICAL MICROLEAKAGE ABSTRACT Aim: The aim of this study was to evaluate the apical microleakage of root-end cavities prepared by Er:YAG (400 mJ, 10 Hz) or Nd:YAG (150 mJ, 10 Hz) laser and the effect of Biodentine by using dye penetration method. Material and Methods: Decoronated sixty-four extracted single-rooted human teeth were prepared using ProTaper® up to F4 and obturated by lateral condensation technique with Guta-perka ve AH plus. The 3-mm of 90° apicoectomy was performed by low-speed diamond burs. The roots were randomly divided into eight groups (n=8) as follows; Group1: Only apicoectomy without a cavity preparation (CP); Group2: Nd:YAG laser after apicoectomy without a CP; Group: CP with bur; Group4: CP/bur and filled with Biodentine; Group5: CP/bur+Nd:YAG irradiation+Biodentine; Group6: CP with Er:YAG; Group7: CP/Er:YAG+Biodentine; Group8: CP/Er:YAG+Nd:YAG irradiation+Biodentine. The root surfaces were coated with a double layer of nail varnish except the retrograde-filled surfaces and roots were immersed in Indian-ink for 15 days. Dye penetration level was assessed with clearing technique. Data were statistically analyzed by using Kruskal-Wallis and Mann Whitney U test. Results: Retrofilling with Biodentine groups showed the lowest microleakage (p<0.05). There was no significant difference apical leakage between the roots-filled Biodentine groups (p>0.05). However; there were statistical significant differences between apicoectomy and apicoectomy+Nd:YAG laser group (p<0.05). Conclusion: Within the limitations of this in vitro study, it can be concluded that retro-filling with Biodentine prevented the apical microleakage. In addition, the treatment of apical surfaces with Nd:YAG laser without a retro-preparation decreases the microleakage in comparison with only apicoectomy. Key Words: Biodentine, Er: YAG laser, Nd: YAG laser, retrograd obturation

Anahtar Kelimeler:

Biodentine, Er: YAG lazer, Nd: YAG lazer

PDF

___

.1. Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006;32:601-23.
2. Mohammadi Z. Laser applications in endodontics: an update review. Int Dent J 2009;59:35-46.
3. Wang N, Knight K, Dao T, Friedman S. Treatment outcome in endodontics-The Toronto Study. Phases I and II: apical surgery. J Endod 2004;30:751-61.
4. Garip H, Garip Y, Orucoglu H, Hatipoglu S. Effect of the angle of apical resection on apical leakage, measured with a computerized fluid filtration device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:50-5.
5. Pereira CL, Cenci MS, Demarco FF. Sealing ability of MTA, Super EBA, Vitremer and amalgam as root-end filling materials. Braz Oral Res 2004;18:317-21.
6. Roy R, Chandler NP, Lin J. Peripheral dentin thickness after root-end cavity preparation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:263-6.
7. Post LK, Lima FG, Xavier CB, Demarco FF, Gerhardt-Oliveira M. Sealing ability of MTA and amalgam in different root-end preparations and resection bevel angles: an in vitro evaluation using marginal dye leakage. Braz Dent J 2010;21:416-9.
8. Cohen S, M.Hargreaves K. Pathways of the pulp. 9th ed. St Louis; C.V. Mosby:2006.p.628.
9. Taschieri S, Testori T, Francetti L, Del Fabbro M. Effects of ultrasonic root end preparation on resected root surfaces: SEM evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:611-8.
10. Bernardes RA, de Moraes IG, Garcia RB, Bernardineli N, Baldi JV, Victorino FR, et al. Evaluation of apical cavity preparation with a new type of ultrasonic diamond tip. J Endod 2007;33:484-7.
11. Ishikawa H, Sawada N, Kobayashi C, Suda H. Evaluation of root-end cavity preparation using ultrasonic retrotips. Int Endod J 2003;36:586-90.
12. Kimura Y, Wilder-Smith P, Matsumoto K. Lasers in endodontics: a review. Int Endod J 2000;33:173-85.
13. Araki AT, Ibraki Y, Kawakami T, Lage-Marques JL. Er:Yag laser irradiation of the microbiological apical biofilm. Braz Dent J 2006;17:296-9.
14. Kato J, Moriya K, Jayawardena JA, Wijeyeweera RL. Clinical application of Er:YAG laser for cavity preparation in children. J Clin Laser Med Surg 2003;21:151-5.
15. Franco EJ AG, Greghi SLA. Comparative evaluation of periodontal radicular therapies conventional. Oral Sci 2005;1:35-42.
16. Oliveira RG, Gouw-Soares S, Baldochi SL, Eduardo CP. Scanning electron microscopy (SEM) and optical microscopy: effects of Er:YAG and Nd:YAG lasers on apical seals after apicoectomy and retrofill. Photomed Laser Surg 2004;22:533-6.
17. Zerbinati LP, Tonietto L, de Moraes JF, de Oliveira MG. Assessment of marginal adaptation after apicoectomy and apical sealing with Nd:YAG laser. Photomed Laser Surg 2012;30:444-50.
18. Baek SH, Plenk H, Jr., Kim S. Periapical tissue responses and cementum regeneration with amalgam, SuperEBA, and MTA as root-end filling materials. J Endod 2005;31:444-9.
19. Grech L, Mallia B, Camilleri J. Characterization of set Intermediate Restorative Material, Biodentine, Bioaggregate and a prototype calcium silicate cement for use as root-end filling materials. Int Endod J 2013;46:632-41.
20. Han L, Okiji T. Uptake of calcium and silicon released from calcium silicate-based endodontic materials into root canal dentine. Int Endod J 2011;44:1081-7.
21. Koubi G, Colon P, Franquin JC, Hartmann A, Richard G, Faure MO, et al. Clinical evaluation of the performance and safety of a new dentine substitute, Biodentine, in the restoration of posterior teeth - a prospective study. Clin Oral Investig 2013;17:243-9.
22. Pawar AM, Kokate SR, Shah RA. Management of a large periapical lesion using Biodentine as retrograde restoration with eighteen months evident follow up. J Conserv Dent 2013;16:573-5.
23. Stabholz A, Khayat A, Weeks DA, Neev J, Torabinejad M. Scanning electron microscopic study of the apical dentine surfaces lased with ND:YAG laser following apicectomy and retrofill. Int Endod J 1992;25:288-91.
24. Birang R, Kiani S, Shokraneh A, Hasheminia SM. Effect of Nd: YAG laser on the apical seal after root-end resection and MTA retrofill: a bacterial leakage study. Lasers Med Sci 2015;30:583-9.
25. Karlovic Z, Pezelj-Ribaric S, Miletic I, Jukic S, Grgurevic J, Anic I. Erbium:YAG laser versus ultrasonic in preparation of root-end cavities. J Endod 2005;31:821-3.
26. Pozza DH, Fregapani PW, Xavier CB, Weber JB, Oliveira MG. CO(2), Er: YAG and Nd:YAG lasers in endodontic surgery. J Appl Oral Sci 2009;17:596-9.
27. Cicek E, Ozsevik A.S, Cortu M, Orucoğlu H. Farklı Kök Ucu Dolgu Materyallerinin Apikal Mikro-Sızıntısı Açısından Bilgisayarlı Sıvı Filtrasyon Metresi ile Değerlendirilmesi. Atatürk Üniv Dis Hek Fak Derg 2015;25:165-71.
28. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. J Endod 2010;36:16-27.
29. Johns DA, Shivashankar VY, Shobha K, Johns M. An innovative approach in the management of palatogingival groove using Biodentine and platelet-rich fibrin membrane. J Conserv Dent 2014;17:75-9.
30. Pathomvanich S, Edmunds DH. The sealing ability of Thermafil obturators assessed by four different microleakage techniques. Int Endod J 1996;29:327-34.
31. Ahlberg KM, Assavanop P, Tay WM. A comparison of the apical dye penetration patterns shown by methylene blue and india ink in root-filled teeth. Int Endod J 1995;28:30-4.
32. Robertson D, Leeb IJ, McKee M, Brewer E. A clearing technique for the study of root canal systems. J Endod 1980;6:421-4.
33. Lucena-Martin C, Ferrer-Luque CM, Gonzalez-Rodriguez MP, Robles-Gijon V, Navajas-Rodriguez de Mondelo JM. A comparative study of apical leakage of Endomethasone, Top Seal, and Roeko Seal sealer cements. J Endod 2002;28:423-6.
34. Gagliani M, Taschieri S, Molinari R. Ultrasonic root-end preparation: influence of cutting angle on the apical seal. J Endod 1998;24:726-30.
35. Gouw-Soares S, Tanji E, Haypek P, Cardoso W, Eduardo CP. The use of Er:YAG, Nd:YAG and Ga-Al-As lasers in periapical surgery: a 3-year clinical study. J Clin Laser Med Surg 2001;19:193-8.
36. Arisu HD, Bala O, Alimzhanova G, Turkoz E. Assessment of morphological changes and permeability of apical dentin surfaces induced by Nd:Yag laser irradiation through retrograde cavity surfaces. J Contemp Dent Pract 2004;5:102-13.
37. Komabayashi T, Spangberg LS. Comparative analysis of the particle size and shape of commercially available mineral trioxide aggregates and Portland cement: a study with a flow particle image analyzer. J Endod 2008;34:94-8.
38. Kocak MM, Kocak S, Aktuna S, Gorucu J, Yaman SD Sealing ability of retrofilling materials following various root-end cavity preparation techniques. Lasers Med Sci 2011;26:427-31.
39. Paghdiwala AF. Root resection of endodontically treated teeth by erbium: YAG laser radiation. J Endod 1993;19:91-4.
40. Pecora JD, Cussioli AL, Guerisoli DM, Marchesan MA, Sousa-Neto MD, Brugnera Junior A. Evaluation of Er:YAG laser and EDTAC on dentin adhesion of six endodontic sealers. Braz Dent J 2001;12:27-30.
41. Caliskan MK, Parlar NK, Orucoglu H, Aydin B Apical microleakage of root-end cavities prepared by Er, Cr: YSGG laser. Lasers Med Sci 2010; 25:145-50.
42. Onay EO, Gogos C, Ungor M, Economides N, Lyssaris V, Ogus E, Lambrianidis T. Effect of Er,Cr:YSGG laser irradiation on apical sealing ability of calcium silicatecontaining endodontic materials in root-end cavities. Dent Mater J 2014; 33:570-5.
43. Nanjappa AS, Ponnappa KC, Nanjamma KK, Ponappa MC, Girish S, Nitin A. Sealing ability of three root-end filling materials prepared using an erbium: Yttrium aluminium garnet laser and endosonic tip evaluated by confocal laser scanning microscopy. J Conserv Dent 2015;18:327-30.
44.Ravichandra PV, Vemisetty H, K D, Reddy SJ, D R, Krishna MJ, et al. Comparative Evaluation of Marginal Adaptation of Biodentine (TM) and Other Commonly Used Root End Filling Materials-An Invitro Study. J Clin Diagn Res 2014;8:243-5.
45. Caron G, Azerad J, Faure MO, Machtou P, Boucher Y. Use of a new retrograde filling material (Biodentine) for endodontic surgery: two case reports. Int J Oral Sci 2014;6:250-3.