Mineral trioksit agregat tıkacı ile yapılan apeksifikasyon tedavisinin başarısının değerlendirilmesi

GİRİŞ ve AMAÇ: Canlılığını yitirmiş, açık apeksli üst keser dişlerde MTA ile tek seans apeksifikasyon tedavisinin klinik ve radyografik başarısının değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Bu çalışma 13-36 yaş aralığında 17 hastaya ait, devital ve açık apeksli 20 adet üst çene ön dişe uygulanan prospektif klinik çalışmadır. Standart giriş kaviteleri açılıp, eski kanal dolguları ya da nekrotik pulpa uzaklaştırıldı. Kök kanalları biyomekanik olarak temizlendi; kalsiyum hidroksit medikamanı ile pansumanı yapıldı. Dişler klinik olarak asemptomatik hale geldiğinde son irigasyon %5’lik EDTA, %2,5’lik NaOCl, distile su ve %2’lik Klorheksidin ile gerçekleştirildi. Kök kanalları kurulandıktan sonra, 3-5 mm kalınlığındaki MTA kök ucuna yerleştirildi. 2-5 gün sonra, kök kanalları guta perka veya fiber post ile dolduruldu, koronaler restorasyon kompozit rezin ile gerçekleştirildi. Hastalar 3, 6, 9,ve 12. aylarda klinik ve radyografik kontrollerine çağrıldı. Olguların toplam takip süreleri 6-12 ay sürdü. Kontrol radyografları iki bağımsız gözlemci tarafından PAI skalasına göre, Simon’ın 2007’de yaptığı klinik çalışmadaki iyileşme kriterleri modifiye edilerek değerlendirildi. BULGULAR: 20 olgunun tümü klinik olarak asemptomatik hale geldi; 2 tanesinde PAI skoru değişmedi ve “şüpheli iyileşme” gözlendi. Olguların 18’inde PAI skoru azalarak, klinik ve radyografik olarak başarılı bulundu. TARTIŞMA ve SONUÇ: MTA kök ucu bariyer uygulamalarında başarılı bir materyaldir. Açık apeksli dişlerin tedavisinde MTA ile tek seans apeksifikasyon uygulamasıyla başarıya ulaşılabilmektedir.

Evaluation the success of apexification with mineral trioxide aggregate as apical plug

INTRODUCTION: The aim of this study is to describe the successful outcome of apexification treatment with MTA plug on devital permanent teeth. METHODS: This prospective study included 20 teeth in 17 patients aged between 13-36 years. Necrotic remnants or root canal treatment materials were removed. Root canals were biomechanically cleaned and filled with calcium hydroxide for 3-4 weeks. When the teeth were asymptomatic, final irrigation was done with 5% EDTA, 2.5% NaOCl, distilled water and 2% chlorhexidine. After drying root canals, MTA was placed as the apical plug. 2-5 days later, the root canals filled by gutta-percha or fiber posts; then coronal restorations were completed with composite resin. Patients were recalled for 3, 6, 9 and 12 months clinical and radiographic follow up. In a blind evaluation, the teeth radiographs were examined with PAI scala, according to the criterias that are modifications of evaluation procedures used by Simon’s study in 2007. RESULTS: At the 6-12 months clinical examination all of the 20 cases were asymptomatic. 18 of the cases were classified as ‘successfull’ radiographycally and clinically. 2 of them showed ‘relative success’. DISCUSSION AND CONCLUSION: MTA is a potantial apical barrier material. Apexification treatment with MTA plug on permanent teeth showed favourable results.

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