Mehmet Kemal ÇALIŞKAN, İlknur KAŞIKÇI BİLGİ

Eğimli Kanallarda Apikal Debris Ekstrüzyonu:Dört Farklı Döner Eğe Sisteminin ve Yer Çekiminin Etkileri

Giriş ve Amaç: Farklı döner eğe sistemleri ile genişletilen kanallardaki apikal debris ekstrüzyonunu incelemek ve yer çekimininetkisini belirlemek Yöntem ve Gereçler: Doksan altı adet eğimli kök kanalı; Twisted File Adaptive, WaveOne, ProTaper Next ve MTwo sistemleri ilegenişletildi. Her grup alt ve üst çene grupları olmak üzere iki alt gruba ayrıldı ve alt ve üst çeneyi taklit eden deneysel bir düzenekkullanıldı. Taşan debris miktarı 10-5 hassasiyetinde hassas tartı ile ölçüldü. Bulgular: Diş pozisyonlarının, eğe sistemleri üzerine apikalden taşan debris miktarı açısından anlamlı bir etkisi görülmedi (p> 0, 05).Ancak eğelerden bağımsız olarak değerlendirildiğinde alt çene pozisyonunda daha fazla debris taştığı gözlemlendi (p< 0, 05). Tartışma ve Sonuç: Tüm eğe sistemlerinde apikalden belli miktarda debris taştığı görüldü. Eğe sistemleri ve yer çekiminin apikaldentaşan debris üzerine etkisi gözlenmedi.

Apical Debris Extrusion in Curved Root Canals: The Effect of Four Rotary Instruments and Influence of Gravitational Force

Introduction: To examine the amount of apically extruded debris produced by different rotary systems in curved root canals and tofind out the effect of gravitational forces on extrusion. Methods: Ninety-six severely curved root canals were instrumented with; Twisted File Adaptive (SybronEndo, Orange, CA, USA),WaveOne (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (Dentsply Maillefer) and Mtwo (VDW, Munich, Germany)systems. Each group was divided into two subgroups of maxillary and mandibular considering their location and a trial model wasused as a phantom head to simulate the upper and lower jaws. The amount of extruded debris was weighed using a 10-5 microbalance. Results: The location of the tooth and the instrument used had no significant effect on the amount of extrusion (p> 0, 05). When thegravitational force was considered regardless of the instruments, significantly more debris was extruded in teeth with mandibularlocation (p< 0, 05). Discussion and Conclusion: All rotary instruments caused apical extrusion of debris. Instrument technique and gravity has no impacton the amount of extruded debris.

PDF

___

1. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004;30:559-67.
2. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. J Endod 1985;11:472-8.
3. Siqueira JF, Jr. Microbial causes of endodontic flare-ups. Int Endod J 2003;36:453-63.
4. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J 2013;47:211-21.
5. Bürklein S, Schafer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 2012;38:850-2.
6. Çapar ID, Arslan H, Akcay M, Ertas H. An in vitro comparison of apically extruded debris and instrumentation times with ProTaper Universal, ProTaper Next, Twisted File Adaptive, and HyFlex instruments. J Endod 2014;40:1638-41.
7. Borges ÁH, Pereira TM, Porto AN, et al. The influence of cervical preflaring on the amount of apically extruded debris after root canal preparation using different instrumentation systems. J Endod 2015;42:465-9.
8. Leonardi LE, Atlas DM, Raiden G. Apical extrusion of debris by manual and mechanical instrumentation. Braz Dent J 2007;18:16-9.
9. Elmsallati EA, Wadachi R, Suda H. Extrusion of debris after use of rotary nickel-titanium files with different pitch: A pilot study. Aust Endod J 2009;35:65-9.
10. De-Deus G, Brandao MC, Barino B, Di Giorgi K, Fidel RA, Luna AS. Assessment of apically extruded debris produced by the single-file ProTaper F2 technique under reciprocating movement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:390-4.
11. Koçak MM, Çiçek E, Koçak S, Sağlam BC, Furuncuoğlu F. Comparison of ProTaper Next and HyFlex instruments on apical debris extrusion in curved canals. Int Endod J 2015; doi: 10.1111/iej.12552.
12. Bürklein S, Benten S, Schafer E. Quantitative evaluation of apically extruded debris with different single-file systems: Reciproc, F360 and One Shape versus Mtwo. Int Endod J 2014;47:405-9.
13. Kaşıkçı Bilgi I, Köseler I, Güneri P, Hülsmann M, Çalıskan MK. Efficiency and apical extrusion of debris: a comparative ex vivo study of four retreatment techniques in severely curved root canals. Int Endod J 2016; doi:10.1111/iej.12708.
14. Pruett JP, Clement DJ, Carnes DL, Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod 1997;23:77-85.
15. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod 1991;17:275-9.
16. Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod 2014;41:237-41.
17. Altundaşar E, Nagaş E, Uyanık O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:31- 5.
18. Yeter K, Evcil M, Ayranci L, Ersoy I. Weight of apically extruded debris following use of two canal instrumentation techniques and two designs of irrigation needles. Int Endod J 2013;46:795-9.
19. Kuştarcı A, Er K. Efficacy of laser activated irrigation on apically extruded debris with different preparation systems. Photomed Laser Surg 2015;33:384-9.
20. Tınaz AC, Alacam T, Uzun O, Maden M, Kayaoglu G. The effect of disruption of apical constriction on periapical extrusion. J Endod 2005;31:533-5.
21. Salzgeber RM, Brilliant JD. An in vivo evaluation of the penetration of an irrigating solution in root canals. J Endod 1977;3:394-8.
22. Silva E, Carapiá M, Lopes R, et al. Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems. Int Endod J 2015; doi: 10.1111/iej.12503.
23. Arslan H, Doğanay E, Alsancak M, Çapar I, Karataş E, Gündüz H. Comparison of apically extruded debris after root canal instrumentation using Reciproc instruments with various kinematics. Int Endod J 2015; doi: 10.1111/iej.12449.
24. De Deus G, Neves A, Silva EJ, et al. Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Invest 2014;19:357-61.
25. McKendry DJ. Comparison of balanced forces, endosonic, and step-back filing instrumentation techniques: quantification of extruded apical debris. J Endod 1990;16:24-7.
26. Üstün Y, Çanakçı B, Dinçer A, Er O, Düzgün S. Evaluation of apically extruded debris associated with several Ni–Ti systems. Int Endod J 2014;48:701-4.
27. Lu Y, Wang R, Zhang L, et al. Apically extruded debris and irrigant with two NiTi systems and hand files when removing root fillings: a laboratory study. Int Endod J 2013;46:1125-30.
28. Caviedes-Bucheli J, Azuero-Holguin MM, Gutierrez-Sanchez L, et al. The effect of three different rotary instrumentation systems on substance P and calcitonin gene-related peptide expression in human periodontal ligament. J Endod 2010;36:1938-42.
29. Caviedes-Bucheli J, Moreno J, Carreño C, et al. The effect of single-file reciprocating systems on Substance P and Calcitonin gene-related peptide expression in human periodontal ligament. Int Endod J 2013;46:419-26.
30. Caviedes-Bucheli J, Rios-Osorio N, Rey-Rojas M, et al. Substance P and Calcitonin gene-related peptide expression in human periodontal ligament after root canal preparation with Reciproc Blue, WaveOne Gold, XP EndoShaper and hand files. Int Endod J 2018;51:1358-66.
31. Caviedes Bucheli J, Castellanos F, Vasquez N, Ulate E, Munoz H. The influence of two reciprocating single file and two rotary file systems on the apical extrusion of debris and its biological relationship with symptomatic apical periodontitis. A systematic review and meta analysis. Int Endod J 2016;49:255-70.