KÖK KANALININ APİKALİNDE YAPAY OLARAK STANDARDİZE EDİLMİŞ OLUKTAN KALSİYUM HİDROKSİTİN UZAKLAŞTIRILMASINDA QMİX SOLÜSYONUNUN ETKİNLİĞİ

Bu çalışmanın amacı kök kanalının apikalinde yapay olarak standardize edilmiş oluklardan kalsiyum hidroksitin (KH) uzaklaştırılmasında QMix 2 in 1 solüsyonunun etkinliğini değerlendirmektir. 118 adet çekilmiş tek köklü üst kanin dişi ProTaper sisteminin F5 boyutundaki eğesine kadar genişletildi. Bu dişler uzunlamasına olarak 2 'ye ayrıldı ve her bir parçanın apikal kısmında standardize edilmiş oluk hazırlandı. Sonrasında bu oluklar distile su ile kalsiyum hidroksit tozunun karıştırılmasıyla elde edilen pat ile dolduruldu ve bu dişler yeniden birleştirildi.  KH’i uzaklaştırmak için dişler aşağıdaki irrigasyon protokolüne göre, rastgele 2 kontrol ve 6 deneysel grubuna ayrıldı. (1) Konvansiyonel şırınga irrigasyonu (KŞİ)/Sodyum Hipoklorit (NaOCl)+Etilendiamin Tetraasetik Asit (EDTA) , (2) QMix/KŞİ, (3) NaOCl+  QMİX /KŞİ, (4) NaOCl+EDTA/Pasif Ultrasonik İrrigasyon (PUİ), (5) QMix/PUİ ve (6) QMix+NaOCl/PUİ. Oluklarda kalan KH miktarı 4 dereceli skorlama sistemi kullanılarak 25 büyütmede stereomikroskop altında değerlendirildi. Veriler Kruskal–Wallis ve Mann–Whitney U istatistiksel testleri kullanılarak değerlendirildi. Yapay standardize edilmiş oluklardaki kalan KH miktarı tüm deneysel gruplarda gözlendi. PUİ/QMix+NaOCl ve PUİ/NaOCl+EDTA diğer gruplara göre KH’i uzaklaştırmada daha etkiliydi  (P < 0.05) ; fakat, PUİ/QMix+NaOCl ve PUİ/NaOCl+EDTA grupları arasında istatistiksel olarak anlamlı fark bulunmadı (P > 0.05). Diğer dört deneysel grup arasında KH’i uzaklaştırma bakımından istatistiksel olarak fark bulunmadı (P > 0.05). İrrigasyon tekniklerinin hiçbirisi, kök kanalının apikalindeki yapay standardize edilmiş oluktan KH’i tam olarak uzaklaştıramadı. Anahtar kelimeler: Kalsiyum Hidroksit, İrrigasyon, NaOCl, QMix, Ultrasonik EFFICACY OF QMIX IN REMOVAL OF CALCIUM HYDROXIDE FROM ARTIFICIAL STANDARDIZED GROOVE IN APICAL ROOT CANALABSTRACT The aim of this study was to evaluate the efficacy of QMix in the removal of calcium hydroxide (CH) from an artificial standardized groove in the apical root canal. One hundred and eighteen extracted single-rooted canine teeth were prepared using ProTaper system instruments up to size F5. The roots were split longitudinally, and a standardized groove was prepared in the apical part of one segment. The grooves were then filled with CH powder mixed with distilled water, and the roots were reassembled. The roots were randomly divided into 6 experimental groups and 2 control groups, according to the following irrigation methods: (1) conventional syringe irrigation (CSI) with sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA), (2) CSI with QMix, (3) CSI with QMix + NaOCl, (4) passive ultrasonic irrigation (PUI) with NaOCl + EDTA, (5) PUI with QMix, and (6) PUI with QMix + NaOCl. The amount of remaining medicament was evaluated under a stereomicroscope at 25 × magnification using a 4-grade scoring system. Data were evaluated using the Kruskal–Wallis and Mann–Whitney U tests. Remnants of CH were found in all experimental groups. PUI/QMix + NaOCl and PUI/NaOCl + EDTA were superior to the other groups (p < 0.05); however, there was no significant difference between the PUI/QMix + NaOCl and PUI/NaOCl + EDTA groups (p > 0.05). There were no significant differences between the other four experimental groups (p > 0.05). None of the irrigation techniques completely removed CH from an artificial standardized groove in an apical root canal. Key words: Calcium hydroxide, Irrigation, NaOCl, QMix, Root canal, Ultrasonic

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  • 1. Siqueira JF Jr, de Uzeda M. Influence of different vehicles on the antibacterial effects of calcium hydroxide. J Endod 1998;24:663-5.
  • 2. Law A, Messer H. An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod 2004;30:689-94.
  • 3. Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011; 44:697-730.
  • 4. Farhad A, Mohammadi Z. Calcium hydroxide: a review. Int Dent J 2005;55:293-301.
  • 5. Böttcher DE, Hirai VH, Da Silva Neto UX, Grecca FS. Effect of calcium hydroxide dressing on the long-term sealing ability of two different endodontic sealers: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:386-9.
  • 6. Calt S, Serper A. Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide. J Endod 1999;25:431-3.
  • 7. Balvedi RP, Versiani MA, Manna FF, Biffi JC. A comparison of two techniques for the removal of calcium hydroxide from root canals. Int Endod J 2010;43:763-8.
  • 8. Rödig T, Vogel S, Zapf A, Hülsmann M. Efficacy of different irrigants in the removal of calcium hydroxide from root canals. Int Endod J 2010;43:519-27.
  • 9. Salgado RJ, Moura-Netto C, Yamazaki AK, Cardoso LN, de Moura AA, Prokopowitsch I. Comparison of different irrigants on calcium hydroxide medication removal: microscopic cleanliness evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:580-4.
  • 10. Kenee DM, Allemang JD, Johnson JD, Hellstein J, Nichol BK. A quantitative assessment of efficacy of various calcium hydroxide removal techniques. J Endod 2006;32:563-5.
  • 11. Alturaiki S, Lamphon H, Edrees H, Ahlquist M. Efficacy of 3 different irrigation systems on removal of calcium hydroxide from the root canal: a scanning electron microscopic study. J Endod 2015;41:97-101.
  • 12. Taşdemir T, Celik D, Er K, Yildirim T, Ceyhanli KT, Yeşilyurt C. Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals. Int Endod J 2011;44:505-9.
  • 13. Bui TB, Baumgartner JC, Mitchell JC. Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin. J Endod 2008;34:181-5.
  • 14. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971;32:271-5.
  • 15. Lee SJ, Wu MK, Wesselink PR. The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J 2004;37:672-8.
  • 16. van der Sluis LW, Wu MK, Wesselink PR. The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J 2007;40:52-7.
  • 17. Arslan H, Gok T, Saygili G, Altintop H, Akçay M, Çapar ID. Evaluation of effectiveness of various irrigating solutions on removal of calcium hydroxide mixed with 2% chlorhexidine gel and detection of orange-brown precipitate after removal. J Endod 2014;40:1820-3.
  • 18. Basrani BR, Manek S, Mathers D, Fillery E, Sodhi RN. Determination of 4-chloroaniline and its derivatives formed in the interaction of sodium hypochlorite and chlorhexidine by using gas chromatography. J Endod 2010;36:312-4.
  • 19. Kolosowski KP, Sodhi RN, Kishen A, Basrani BR. Qualitative analysis of precipitate formation on the surface and in the tubules of dentin irrigated with sodium hypochlorite and a final rinse of chlorhexidine or QMiX. J Endod 2014;40:2036-40.
  • 20. Capar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA. Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod 2014;40:451-4.
  • 21. Lee SJ, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different-sized simulated plastic root canals. Int Endod J 2004;37:607-12.
  • 22. Jiang LM, Verhaagen B, Versluis M, van der Sluis LW. Influence of the oscillation direction of an ultrasonic file on the cleaning efficacy of passive ultrasonic irrigation. J Endod 2010;36:1372-6