Ertuğrul KARATAŞ, Ezgi DOĞANAY YILDIZ, Hakan ARSLAN

Apikalden Taşmış Gutaperka Parçasının Çıkarılması İçin Negatif Apikal Basınç Tekniğinin Kullanımı – Bir Olgu Sunumu

Bu vaka raporunun amacı kanal yenileme işlemleri sırasında apikalden taşmış gutaperka parçasının çıkarılması için negatif apikal basınç tekniği kullanımının sunulmasıdır. 22 yaşında bir kadın hasta #26 numaralı dişinde şiddetli ağrı, şişlik, ve perküsyon ve palpasyona hassasiyet sebebiyle kliniğimize başvurdu. Periapikal radyograf #26 numaralı dişinde kök kanal dolumu yetersiz olan önceden yapılmış kanal tedavisi olduğunu gösterdi. Kanal yenileme işlemleri sırasında, gutaperka mezial kök kanalının apikalinden taştı. Hasta bir gün sonra tekrar çağrıldı. İkinci seansta, şişliğin arttığı gözlendi. Kalsiyum hidroksit patını uygulamak için kullanılan uçlarından biri dental ünitin aspiratörüne adapte edildi. Uç kanalda mümkün olduğunca derine yerleştirildi. Birkaç denemeden sonra, apikalden taşmış gutaperka çıkarıldı ve hasta bir gün sonra tekrar çağrıldı. Parçanın çıkarılmasından bir gün sonra, şişlik azaldı. Kanallara bir hafta süreyle kalsiyum hidroksit yerleştirildi. Dördüncü seansta, hasta asemptomatikti ve tedavi bu seansta tamamlandı.

Use of Negative Apical Pressure Technique for Removal of Apically Extruded Gutta-percha Fragment – A Case Report

The aim of this case report was to present using negative apical pressure technique for removal of apically extruded gutta-percha during retreatment procedures. A 22 year-old female patient was referred to the clinic with severe pain, swelling, and tenderness to percussion and palpation in the tooth of #26. Periapical radiograph showed previous root canal treatment of tooth #26 with incomplete root canal fillings. During retreatment procedures gutta-percha apically extruded from mesial root canal. The patient was recalled after one day. At the second session, it was observed that the swelling was increased. One of the tips for calcium hydroxide paste application was adjusted to suction of dental unit. Tip was placed into the canal as deep as possible. After a few attempts, apically extruded gutta-percha was removed and the patient was recalled after one day. At one day from the fragment removal, the swelling was decreased. Calcium hydroxide paste was placed into the canals for one week. At the fourth session, the patient was asymptomatic and the treatment was completed at this session.

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1. Chugal N, Mallya SM, Kahler B, Lin LM. Endodontic Treatment Outcomes. Dent Clin North Am. 2017;61:59-80.
2. Lin LM, Skribner JE, Gaengler P. Factors associated with endodontic treatment failures. J Endod. 1992;18:625-7.
3. Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? J Am Dent Assoc. 2005;136:187-93; quiz 231.
4. Paik S, Sechrist C, Torabinejad M. Levels of evidence for the outcome of endodontic retreatment. J Endod. 2004;30:745-50.
5. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009;35:930-7.
6. Rechenberg DK, Paque F. Impact of cross-sectional root canal shape on filled canal volume and remaining root filling material after retreatment. Int Endod J. 2013;46:547-55.
7. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. 1985. J Endod. 2004;30:472-8.
8. Somma F, Cammarota G, Plotino G, Grande NM, Pameijer CH. The effectiveness of manual and mechanical instrumentation for the retreatment of three different root canal filling materials. J Endod. 2008;34:466-9.
9. Kesim B, Ustun Y, Aslan T, Topcuoglu HS, Sahin S, Ulusan O. Efficacy of manual and mechanical instrumentation techniques for removal of overextended root canal filling material. Niger J Clin Pract. 2017;20:761-66.
10. Ruiz-Hubard EE, Gutmann JL, Wagner MJ. A quantitative assessment of canal debris forced periapically during root canal instrumentation using two different techniques. J Endod. 1987;13:554-8.
11. Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod. 2011;37:1516-9.
12. Tronstad L, Asbjornsen K, Doving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol. 2000;16:218-21.
13. Cheung GS. Survival of first-time nonsurgical root canal treatment performed in a dental teaching hospital. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:596-604.
14. Hoen MM, Pink FE. Contemporary endodontic retreatments: an analysis based on clinical treatment findings. J Endod. 2002;28:834-6.
15. Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PM. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int Endod J. 2011;44:162-9.