Evaluation of Double and Triple Antibiotic Paste Removal Efficiency of Various Irrigation Protocols

Objective: Aim of this study was to compare the double (DAP) and triple (TAP) antibiotic paste removal efficiency of conventional syringe irrigation (CSI), EndoActivator (EA), passive ultrasonic irrigation (PUI) and XP-endo finisher (XPF) from simulated immature root canals. Materials and Methods: A total of 180 extracted mandibular canine roots were used. The apical 2 mm of the roots were removed, and Unicore drills were penetrated through the apical to the coronal direction approximately 1 mm to simulate an immature apex. Canals were prepared up to size 40 by using the Mtwo system. Roots were split longitudinally and then temporarily reassembled. The samples were randomly divided into 2 main groups as DAP and TAP. Five specimens for each main group were kept as negative control group. Then the pastes were placed with lentulo spiral. After 1 week five specimens for each main group were kept as positive control group. Then the remaining specimens in DAP and TAP groups were further assigned to 4 subgroups according to the removal technique (group 1: CSI; group 2: EA; group 3: PUI, group 4: XPF). The root halves were examined under a stereomicroscope at 10x magnification. Kruskal-Wallis H and Mann-Whitney U tests were used for statistical analyses. Results: TAP and DAP were more effectively removed by XPF and PUI compared to CSI and EA (p0.05). Moreover, CSI and EA showed similar effectiveness for both paste groups (p>0.05). Regarding the type of antibiotic paste, no significant difference between TAP and DAP was found (p>0.05). Conclusion: The tested irrigation systems could not completely remove either TAP or DAP. The use of PUI or the XPF was more effective compared to the use of the EA and CSI.

Çeşitli İrrigasyon Protokollerinin İkili ve Üçlü Antibiyotik Patlarını Uzaklaştırma Etkinliklerinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı konvansiyonel şırınga irrigasyonu (KŞİ), EndoActivator (EA), pasif ultrasonik irrigasyon (PUİ), ve XP-endo finisher (XPF) ile ikili (DAP) ve üçlü (TAP) antibiyotik patlarının uzaklaştırılabilme etkinliğinin karşılaştırılması amaçlanmaktır. Gereç ve Yöntemler: Toplam 180 adet çekilmiş mandibular kanin diş kullanılmıştır. Köklerin apikal 2 mm kısmı uzaklaştırılmıştır ve unicore frezler ile apikalden koronal yöne doğru yaklışık 1 mm ilerlenerek immature apeks simule edilmiştir. Kanallar Mtwo sistemiyle 40 numara genişliğine kadar prepare edilmiştir. Kökler longitudinal olarak ikiye ayrıldı ve sonrasında geçici olarak yeniden birleştirildi. Örnekler rastgele DAP ve TAP olarak iki ana gruba ayrıldı. Her ana grup için beşer numune negatif kontrol grubu olarak ayrıldı. Sonrasında lentulo ile patlar yerleştirildi. Bir hafta sonra her ana grup için beşer numune pozitif kontrol grubu olarak ayrıldı. Sonrasında DAP ve TAP gruplarındaki kalan numuneler uzaklaştırma yöntemine göre dörder alt gruba ayrıldı (grup 1: KŞİ; grup 2: EA; grup 3: PUİ, grup 4: XPF). Kök yarıları 10X büyütmede stereo mikroskop ile incelendi. Kruskal-Wallis H ve Mann-Whitney U testleri istatiksel analizlerde kullanıldı. Bulgular: XPF ve PUI, KŞİ ve EA’ya kıyasla daha etkin olarak TAP ve DAP uzaklaştırmıştır (p0,05). Dahası, KSİ ve EA de her iki antibiyotik patı için benzer etkinlik göstermiştir (p>0,05). Antibiyotik patı tiplerine bakıldığında ise TAP ve DAP arasında anlamlı farklılık bulunamamıştır (p>0,05). Sonuç: Test edilen irrigasyon sistemlerinin hiçbirisi TAP yada DAP’yi tamamen uzaklaştıramamıştır. PUI veya XPF kullanımı EA ve KSİ ile kıyaslandığında daha etkilidir.

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