YENİ SONİK SİSTEM VİBRİNGE İLE FARKLI İRRİGASYON SİSTEMLERİNİN KÖK KANALLARINDAN KALSİYUM HİDROKSİT UZAKLAŞTIRMA ETKİNLİKLERİNİN KARŞILAŞTIRILMASI

Amaç: Bu çalışmanın amacı, Vibringe, EndoVac, pasif ultrasonik (PUI) ve geleneksel şırınga irrigasyonunun (GSI) kök kanallarından kalsiyum hidroksit (CH) uzaklaştırma etkinliklerinin taramalı elektron mikroskop (SEM) yardımı ile değerlendirilmesidir. Gereç ve Yöntem: Bu çalışma için 70 adet tek köklü insan mandibular premolar diş kullanıldı. Örnekler ProTaper döner sistem ile F4'e kadar prepare edildi ve kalsiyum hidroksit ile dolduruldu. Bir hafta sonra, kalsiyum hidroksit kök kanallarından GSI (Grup 1) , Vibringe (Grup 2) , EndoVac, (Grup 3) ve PUI (Grup 4) yöntemleri kullanılarak uzaklaştırıldı. İşlemler sırasında, her örnek için toplamda altı dakika boyunca (aktif ve pasif irrigasyon) 2.5 mL % 2.5’lik NaOCI ve ardından 2.5 mL’lik % 17’lik EDTA kullanıldı. Kalan kalsiyum hidroksit miktarının değerlendirilmesi için kökler uzunlamasına ikiye ayrıldı ve x50 ve x1000 büyütme altında SEM’de incelendi. Veriler Kruskal-Wallis ve Mann-Whitney U testleri ile istatistiksel olarak analiz edildi (α = 0.05). Bulgu: Çalışmada kullanılan yöntemlerinden hiçbirisi kök kanal duvarlarından kalsiyum hidroksit medikamentini tamamen uzaklaştıramadı.. GSI sonrasında kanal duvarlarında en fazla kalsiyum hidroksit artığına rastlanırken, Vibringe, EndoVac ve PUI yöntemleri arasında anlamlı fark tespit edilmedi.(p> 0.05) Bununla birlikte GSI yönteminde apikal bölgede, koronal ve orta üçlüye göre anlamlı oranda daha fazla kalsiyum hidroksit artığına rastlanıldı. (p = 0.017) Vibringe, EndoVac ve PUI yöntemlerinin temizleme etkinliği ise kanal üçlü bölgelerine göre anlamlı farklılık göstermedi. Sonuç: Kök kanallarından kalsiyum hidroksit uzaklaştırmada Vibringe, EndoVac ve PUI yöntemleri birbirlerine benzer temizleme etkinliği göstermiş ve bu üç teknik de GSI metodundan daha başarılı bulunmuştur. Anahtar kelimeler: Kalsiyum hidroksit, Vibringe, EndoVac, Pasif Ultrasonik İrrigasyon, SEM Comparison of Calcium Hydroxide Removal Activities from Root Canals of New Sonic System Vibringe and Different Irrigation Systems ABSRACT Objectives: The aim of this study was to evaluate the removal efficiencies of calcium hydroxide (CH) from the root canals using Vibringe, EndoVac, passive ultrasonic (PUI) and conventional needle irrigation (GSI) by means of scanning electron microscopy (SEM). Materials and Methods: Seventy single-rooted human mandibular premolar teeth were used for this study. The samples were prepared with the Protaper rotary system up to F4 and filled with calcium hydroxide. One week later, Calcium hydroxide was removed from the root canals with the several irrigation methods as follows: GSI (Group 1), Vibringe (Group 2), EndoVac (Group 3), PUI (Group 4). During the irrigation procedure, for each sample, 2.5 mL of 2.5% NaOCl followed by 2.5 mL of 17% EDTA was used for six minutes totally (active and passive irrigation). For the evaluation of remaining calcium hydroxide, the roots were split longitudinally and evaluated under SEM at x50 and x1000. Data were analyzed statistically by Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: None of the methods used in the study could completely remove the calcium hydroxide medication from the root canal walls. Although the most residuel calcium hydroxide was observed on the canal walls after GSI irrigation, there was no significant difference between Vibringe, EndoVac and PUI methods (p> 0.05). However, GSI method showed significantly more calcium hydroxide residues in the apical region (p=0.017) than the coronal and middle area. The cleaning efficiency of the Vibringe, EndoVac and PUI methods were not significantly different in root canal areas. Conclusions: In terms of calcium hydroxide removal from root canals, Vibringe, EndoVac and PUI methods were found to be more effective than the GSI; however, there was no significant difference could be detected between each other. Key Words: Calcium Hydroxide, Vibringe, EndoVac, Passive Ultrasonic İrrigation, SEM

Anahtar Kelimeler:

Kalsiyum hidroksit, Vibringe, EndoVac, Pasif Ultrasonik İrrigasyon

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1. Hülsmann M, Peters OA, Dummer PM. Mechanical preparation of root canals: shaping goals, techniques and means. Endodontic Topics, 2005, 10: 30-76.
2. Law A, Messer H. An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments. Journal of endodontics, 2004, 30: 689-694.
3. Farhad A, Mohammadi Z. Calcium hydroxide: a review. International dental journal, 2005, 55: 293-301.
4. Gu L-s, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. Journal of endodontics, 2009, 35: 791-804.
5. Clarkson RM, Moule AJ. Sodium hypochlorite and its use as an endodontic irrigant. Australian dental journal, 1998, 43: 250-256.
6. Van der Sluis L, Gambarini G, Wu M, Wesselink P. The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. International endodontic journal, 2006, 39: 472-476.
7. Lambrianidis TP. Risk management in root canal treatment. Baskı. University Studio Press, 2001.
8. Pashley E, Nelson R, Pashley DH. Pressures created by dental injections. Journal of dental research, 1981, 60: 1742-1748.
9. Schoeffel GJ. The EndoVac method of endodontic irrigation: safety first. Dent Today, 2007, 26: 92, 94, 96 passim.
10. Nielsen BA, Baumgartner JC. Comparison of the EndoVac system to needle irrigation of root canals. Journal of endodontics, 2007, 33: 611-615.
11. Bradford C, Eleazer P, Downs K, Scheetz J. Apical pressures developed by needles for canal irrigation. Journal of endodontics, 2002, 28: 333-335.
12. Weller RN, Brady JM, Bernier WE. Efficacy of ultrasonic cleaning. J Endod, 1980, 6: 740-743.
13. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod, 2009, 35: 791-804.
14. Sjögren U, Sundqvist G. Bacteriologic evaluation of ultrasonic root canal instrumentation. Oral surgery, oral medicine, oral pathology, 1987, 63: 366-370.
15. GRIFFITHS BM, Stock C. The efficiency of irrigants in removing root canal debris when used with an ultrasonic preparation technique. International endodontic journal, 1986, 19: 277-284.
16. Ricardo S, Nursasongko B. Comparison of Apical Third Cleanliness of Smear Layer Using Endoactivator® and Vibringe®. Journal of International Dental & Medical Research, 2016, 9.
17. Düzgün S, Topçuoğlu HS, Akpek F, Topçuoğlu G, Ulusan Ö, Ahmet A. Kök Kanalının Apikalinde Yapay Olarak Standardize Edİlmiş Oluktan Kalsiyum Hİdroksitin Uzaklaştırılmasında Qmix Solüsyonunun Etkinliği. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 2017, 27: 94-99.
18. Hosoya N, Kurayama H, Iino F, Arai T. Effects of calcium hydroxide on physical and sealing properties of canal sealers. International endodontic journal, 2004, 37: 178-184.
19. Ring KC, Murray PE, Namerow KN, Kuttler S, Garcia-Godoy F. The comparison of the effect of endodontic irrigation on cell adherence to root canal dentin. Journal of endodontics, 2008, 34: 1474-1479.
20. Rödig T, Bozkurt M, Konietschke F, Hülsmann M. Comparison of the vibringe system with syringe and passive ultrasonic irrigation in removing debris from simulated root canal irregularities. Journal of endodontics, 2010, 36: 1410-1413.
21. Salgado RJC, Moura-Netto C, Yamazaki AK, Cardoso LN, de Moura AAM, Prokopowitsch I. Comparison of different irrigants on calcium hydroxide medication removal: microscopic cleanliness evaluation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009, 107: 580-584.
22. de Oliveira RL, Guerisoli DM, Duque JA, Alcalde MP, Onoda HK, Domingues FHF, Vivan RR, Duarte MA. Computed microtomography evaluation of calcium hydroxide‐based root canal dressing removal from oval root canals by different methods of irrigation. Microscopy research and technique, 2019.
23. Moreira DM, Almeida JFA, Ferraz CCR, de Almeida Gomes BPF, Line SRP, Zaia AA. Structural analysis of bovine root dentin after use of different endodontics auxiliary chemical substances. Journal of endodontics, 2009, 35: 1023-1027.
24. 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. Journal of endodontics, 2015, 41: 1108-1111.
25. Saif S, Carey CM, Tordik PA, McClanahan SB. Effect of irrigants and cementum injury on diffusion of hydroxyl ions through the dentinal tubules. Journal of endodontics, 2008, 34: 50-52.
26. Kishen A, Sum C-P, Mathew S, Lim C-T. Influence of irrigation regimens on the adherence of Enterococcus faecalis to root canal dentin. Journal of endodontics, 2008, 34: 850-854.
27. Yücel AÇ, Gürel M, Güler E, Karabucak B. Comparison of final irrigation techniques in removal of calcium hydroxide. Australian Endodontic Journal, 2013, 39: 116-121.
28. Faria G, Kuga MC, Ruy AC, Aranda-Garcia AJ, Bonetti-Filho I, Guerreiro-Tanomaru JM, Leonardo RT. The efficacy of the self-adjusting file and ProTaper for removal of calcium hydroxide from root canals. Journal of Applied Oral Science, 2013, 21: 346-350.
29. Gregory SD, Stevens MC, Pauls JP, Schummy E, Diab S, Thomson B, Anderson B, Tansley G, Salamonsen R, Fraser JF. In vivo evaluation of active and passive physiological control systems for rotary left and right ventricular assist devices. Artificial organs, 2016, 40: 894-903.
30. Hülsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. International endodontic journal, 2003, 36: 810-830.
31. Parente J, Loushine R, Susin L, Gu L, Looney SW, Weller R, Pashley DH, Tay F. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. International endodontic journal, 2010, 43: 1001-1012.
32. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. Journal of endodontics, 2009, 35: 545-549.
33. Schoeffel GJ. The EndoVac method of endodontic irrigation, Part 3: System components and their interaction. Dentistry today, 2008, 27: 106, 108-111.
34. Schoeffel GJ. The EndoVac method of endodontic irrigation, part 2--efficacy. Dentistry today, 2008, 27: 82, 84, 86-87.
35. Jiang L-M, Verhaagen B, Versluis M, van der Sluis LW. Evaluation of a sonic device designed to activate irrigant in the root canal. Journal of endodontics, 2010, 36: 143-146.
36. Shin S-J, Kim H-K, Jung I-Y, Lee C-Y, Lee S-J, Kim E. Comparison of the cleaning efficacy of a new apical negative pressure irrigating system with conventional irrigation needles in the root canals. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2010, 109: 479-484.
37. 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. Journal of endodontics, 2015, 41: 97-101.
38. Khademi A, Yazdizadeh M, Feizianfard M. Determination of the minimum instrumentation size for penetration of irrigants to the apical third of root canal systems. Journal of endodontics, 2006, 32: 417-420.
39. 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. Journal of endodontics, 2014, 40: 451-454.
40. Gokturk H, Ozkocak I, Buyukgebiz F, Demir O. Effectiveness of various irrigation protocols for the removal of calcium hydroxide from artificial standardized grooves. Journal of Applied Oral Science, 2017, 25: 290-298.
41. Topçuoğlu HS, Aktı A, Topçuoğlu G, Düzgün S, Ulusan Ö, Akpek F. Effectiveness of conventional syringe irrigation, vibringe, and passive ultrasonic irrigation performed with different irrigation regimes in removing triple antibiotic paste from simulated root canal irregularities. Journal of conservative dentistry: JCD, 2016, 19: 323.
42. Balvedi R, Versiani M, Manna F, Biffi J. A comparison of two techniques for the removal of calcium hydroxide from root canals. International endodontic journal, 2010, 43: 763-768.
43. Ballal N, Kumar S, Laxmikanth H, Saraswathi M. Comparative evaluation of different chelators in removal of calcium hydroxide preparations from root canals. Australian dental journal, 2012, 57: 344-348.
44. Lambrianidis T, Margelos J, Beltes P. Removal efficiency of calcium hydroxide dressing from the root canal. Journal of endodontics, 1999, 25: 85-88.
45. Lambrianidis T, Kosti E, Boutsioukis C, Mazinis M. Removal efficacy of various calcium hydroxide/chlorhexidine medicaments from the root canal. International endodontic journal, 2006, 39: 55-61.
46. Kuga MC, Tanomaru-Filho M, Faria G, Só MVR, Galletti T, Bavello JRS. Calcium hydroxide intracanal dressing removal with different rotary instruments and irrigating solutions: a scanning electron microscopy study. Brazilian dental journal, 2010, 21: 310-314.
47. Ribeiro EM, Silva‐Sousa YT, Souza‐Gabriel AE, Sousa‐Neto MD, Lorencetti KT, Silva SRC. Debris and smear removal in flattened root canals after use of different irrigant agitation protocols. Microscopy research and technique, 2012, 75: 781-790.
48. Faria G, Viola KS, Kuga MC, Garcia AJA, Daher VB, Leonardo MF, Tanomaru‐Filho M. Effect of rotary instrument associated with different irrigation techniques on removing calcium hydroxide dressing. Microscopy research and technique, 2014, 77: 642-646.