Burcu ŞEREFOĞLU, Gözde KANDEMİR DEMİRCİ, Mehmet Kemal ÇALIŞKAN, İlknur KAŞIKÇI BİLGİ, Seniha MIÇOOĞULLARI KURT

Kök Kanal Eğiminin ve Enstrüman Tipinin Apikalden Taşan Debris Miktarına Etkisi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı kök kanal eğiminin ve farklı NiTi enstrümantasyon sistemlerinin apikalden taşan debris miktarıüzerindeki etkisinin değerlendirilmesidir. YÖNTEM ve GEREÇLER: Çalışmada kök gelişimini tamamlamış 84 adet eğimli ve 84 adet düz kök kanalı kullanıldı. Eğimli ve düzkökler kendi içlerinde 3 gruba ayrılarak, kök kanal şekillendirmeleri Twisted File Adaptive (TFA), ProTaper Next (PTN) ve WaveOneGold (WOG) sistemleri ile gerçekleştirildi. Her sistemle uygulanan kök kanal şekillendirmesi sırasında apikalden taşan yıkamasolüsyonu ve debris önceden ağırlığı belirlenmiş cam tüplere toplandı. Solüsyon buharlaştırıldıktan sonra tüpün ağırlığı 10-5 hassastartı kullanılarak ölçüldü ve tüpün son ağırlığından ilk ağırlık çıkartılarak taşan debris miktarı belirlendi. Elde edilen veriler t testi ve tekyönlü Anova testi ile değerlendirildi. BULGULAR: Her eğe sistemi için kök kanal eğiminin taşan debris miktarı üzerinde etkisi olmadığı gözlendi (P > 0.05). Tüm sistemlerdedebris taşması meydana geldi ve hem eğimli hem de düz köklü dişlerde sistemler arasında istatistiksel fark gözlenmedi (P > 0.05).TARTIŞMA ve SONUÇ: Test edilen farklı kinematiklere sahip tüm eğe sistemlerinin debris ekstrüzyonuna neden olduğu ve kök kanaleğiminin apikal debris ekstrüzyonu üzerinde etkisinin olmadığı sonucuna varılmıştır.

Effect of Canal Curvature and Instrument Type on theAmount of Apically Extruded Debris

INTRODUCTION: The aim of this study was to evaluate the effect of the curvature on the amount of apically extruded debris causedby three NiTi systems using different kinematics via including straight and severely curved root canals.METHODS: 84 severely curved and 84 straight mature root canals were instrumented with; Twisted File Adaptive (TFA), ProTaperNext (PTN) and WaveOne Gold (WOG) systems. The extruded debris and irrigant was collected into pre weighed glass tubes andweighed by using a 10-5 microbalance after the evaporation of irrigant. The effect of curvature on debris extrusion were analysed witht test and the amount of debris extrusion between the file systems was compared with One-way ANOVA test at a 0.05 level ofsignificance.RESULTS: Within each file system, the amount of extruded debris was similar for curved and straight canals (p > 0.05). The testedinstruments showed no significant differences in amount of extruded debris for both straight and curved root canals (p > 0.05), withthe following ranking order: PTN > WOG > TFA. DISCUSSION AND CONCLUSION: It can be concluded that all the tested instruments with different kinematics caused debrisextrusion and the curvature of the root canal has no effect on apical debris extrusion.

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1. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J 2014; 47:211-221.
2. Bürklein S, Benten S, Schäfer E. Quantitative evaluation of apically extruded debris with different single-file systems: Reciproc, F360 and OneShape versus Mtwo. Int Endod J 2014; 47:405-409.
3. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. 1985. J Endod 2004; 30:476-481.
4. Siqueira JF Jr. Microbial causes of endodontic flareups. Int Endod J 2003; 36:453-463. 5. Bürklein S, Schäfer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 2012; 38:850-852.
6. Capar ID, Arslan H, Akcay M, et al. 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; 40:1638-1641.
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 2016; 42:465-469.
8. Leonardi LE, Atlas DM, Raiden G. Apical extrusion of debris by manual and mechanical instrumentation. Braz Dent J 2007; 18:16-19.
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; 35:65-69.
10. De-Deus G, Neves A, Silva EJ, et al. Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig 2015; 19:357-361.
11. Karataslioglu E, Arslan H, Er G, et al. Influence of canal curvature on the amount of apically extruded debris determined by using three-dimensional determination method. Aust Endod J 2019; 45:216-224.
12. Kaşıkçı Bilgi I, Köseler I, Güneri P, et al. Efficiency and apical extrusion of debris: a comparative ex vivo study of four retreatment techniques in severely curved root canals. Int Endod J 2017; 50:910-918.
13. Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod 1997; 23:77-85.
14. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod 1991; 17:275- 279.
15. Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod 2015; 41:237-241.
16. Tinaz AC, Alacam T, Uzun O, et al. The effect of disruption of apical constriction on periapical extrusion. J Endod 2005; 31:533-535.
17. Silva EJ, Carapiá MF, Lopes RM, et al. Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems. Int Endod J 2016; 49:700- 705.
18. Hinrichs RE, Walker WA 3rd, Schindler WG. A comparison of amounts of apically extruded debris using handpiece-driven nickel-titanium instrument systems. J Endod 1998; 24:102-106.
19. Altundasar E, Nagas E, Uyanik O, et al. 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.
20. Lu Y, Wang R, Zhang L, et al. Apically extruded debris and irrigant with two Ni-Ti systems and hand files when removing root fillings: a laboratory study. Int Endod J 2013; 46:1125-1130.
21. Berutti E, Chiandussi G, Paolino DS, et al. Effect of canal length and curvature on working length alteration with WaveOne reciprocating files. J Endod 2011; 37:1687-1690.
22. Bürklein S, Jäger PG, Schäfer E. Apical transportation and canal straightening with different continuously tapered rotary file systems in severely curved root canals: F6 SkyTaper and OneShape versus Mtwo. Int Endod J 2017; 50:983 – 90.
23. Bürklein S, Flüch S, Schäfer E. Shaping ability of reciprocating single-file systems in severely curved canals: WaveOne and Reciproc versus WaveOne Gold and Reciproc blue. Odontology 2019; 107:96- 102.
24. Üstün Y, Çanakçi BC, Dinçer AN, et al. Evaluation of apically extruded debris associated with several Ni-Ti systems. Int Endod J 2015; 48:701-704.
25. Arslan H, Doğanay E, Alsancak M, et al. Comparison of apically extruded debris after root canal instrumentation using Reciproc instruments with various kinematics. Int Endod J 2016; 49:307- 310.
26.Boijink D, Costa DD, Hoppe CB, et al. Apically Extruded Debris in Curved Root Canals Using the WaveOne Gold Reciprocating and Twisted File Adaptive Systems. J Endod 2018; 44:1289-1292.