Dört Direkt Pulpa Kaplama Materyalinin Klinik Takip Sonuçlarının Değerlendirilmesi
Amaç: Bu çalışmanın amacı, çürükten dolayı ekspoze olmuş matur daimi dişlerin Ca(OH)2, Biodentine, MTA ve TheraCal LC pulpa kaplama materyalleri ile tedavisi sonrası klinik olarak takip sonuçlarının 1 yıl boyunca değerlendirilmesidir. Gereç ve Yöntemler: Bu takip çalışmasına, Restoratif Diş Tedavisi kliniğine çürük semptomları nedeniyle başvurmuş, çürük uzaklaştırma esnasında ekspoze olmuş pulpa üzerine rastgele farklı pulpa kaplama materyalleri (Ca(OH)2, Biodentine, MTA ve TheraCal LC) kullanılarak direkt pulpa kaplama tedavisi uygulanmış hastalar dahil edildi. Bu hastalar arasından 18-45 yaş aralığında, sistemik sağlık problemi olmayan, her bir pulpa kaplama materyaline ait grupta yaklaşık eşit sayıda hasta olacak şekilde toplam 94 hasta dahil edildi. Hastalar tedavide kullanılan pulpa kaplama materyallerine göre 4 farklı gruba ayrıldı. Grup 1:Ca(OH)2 (Kerr,ABD) (n=25), Grup 2:MTA(Angelus,Brezilya) (n=25), Grup 3:TheraCal LC (Bisco Inc,ABD) (n=22) ve Grup 4:Biodentine (Septodont,Fransa) (n=22) idi. Hastaların klinik takipleri 1., 3., 6. ve 12. aylarda gerçekleştirildi. Klinik takipler için gelen hastaların spontan ağrı, perküsyon, postoperatif hassasiyet şikayetleri değerlendirildi, soğuk testi (Endo Ice, Coltene/Whaledent, Switzerland) ve elektrikli vitalite testi (Digitest II, Parkell, USA) ile tedavi edilen dişlerin canlılıkları ölçüldü. İstatistiksel analiz için Ki- Kare testi ve Fisher Exact testi kullanıldı (p
Evaluation of The Clinical Follow-up Results of Four Direct Pulp Capping Materials
Background: This study aimed to evaluate the clinical performance of Ca(OH)2, Biodentine, MTA and TheraCal LC in cariously exposed mature permanent teeth for one year after treatment. Methods: In this follow-up study, patients who applied to the Restorative Dentistry clinic due to caries symptoms, and were randomly applied pulp capping treatment using different pulp capping materials (Ca(OH)2, Biodentine, MTA and TheraCal LC) on the pulp that was exposed during caries removal were included. Among these patients, a total of 94 patients between the ages of 18-45, who had no systemic health problems and had approximately equal number of patients in each pulp capping material group were included. The patients in Group 1, 2, 3 and 4 were treated with Ca(OH)2 (Kerr, USA) (n=25), MTA(Angelus, Brasil) (n=25), TheraCal LC (Bisco Inc,USA) (n=22) and Biodentine(Septodont,France) (n=22), respectively. The patients were recalled for clinical evaluation after 1, 3, 6, and 12 months. Presence of spontaneous pain, percussion, and postoperative hypersensitivity, and tooth vitality were recorded. The vitality tests were done by both, cold (Endo Ice, Coltene/Whaledent, Switzerland) and electric pulp tests (Digitest II, Parkell, USA). The Chi-Square and Fisher Exact tests were used for statistical analysis (p
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- 1. Brizuela C, Ormeño A, Cabrera C, Cabezas R, Silva CI, Ramírez V, et al. Direct pulp capping with calcium hydroxide, mineral trioxide aggregate, and biodentine in permanent young teeth with caries: a randomized clinical trial. J Endod 2017;43:1776-80.
- 2. Suhag K, Duhan J, Tewari S, Sangwan PJ. Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up. J Endod 2019;45:840-47.
- 3. Li Z, Cao L, Fan M, Xu Q. Direct pulp capping with calcium hydroxide or mineral trioxide aggregate: a meta-analysis. J Endod 2015;41:1412-7.
- 4. Dummett CO, Kopel HM. Pediatric Endodontics. Ingle JI, Bakland LK, editors. Endodontics 5th Edition. BC Decker Inc; 2002. p. 861-902.
- 5. Dammaschke T. The history of direct pulp capping. J Hist Dent 2008;56;9-23.
- 6. Qureshi A, Soujanya E, Nandakumar, Pratapkumar, Sambashivarao. Recent advances in pulp capping materials: an overview. J Clin Diagn Res 2014;8:316- 21.
- 7. Ghoddusi J, Forghani M, Parisay I. New approaches in vital pulp therapy in permanent teeth. Iran Endod J 2014;9:15-22.
- 8. Matsuura T, Kawata-Matsuura VKS, Yamada S. Long-term clinical and radiographic evaluation of the effectiveness of direct pulp-capping materials. J Oral Sci 2019;28:18-0125.
- 9. Asgary S, Shahabi S, Jafarzadeh T, Amini S, Kheirieh S. The properties of a new endodontic material. J Endod 2008;34:990-93.
- 10.Bhavana V, Chaitanya KP, Gandi P, Patil J, Dola B, Reddy RB. Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement. J Conserv Dent 2015;18:44-6.
- 11.Türkyılmaz A, Erdemir A. Endodonti’de Mineral Trioksit Aggregate. On Dokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi Dergisi;12:43-51.
- 12.Kaur M, Singh H, Dhillon JS, Batra M, Saini M. MTA versus biodentine: Review of literature with a comparative analysis. J Clin Diagn Res 2017;11:ZG01-ZG05.
- 13.Rajasekharan S, Martens LC, Cauwels RGEC, Verbeeck RMH. Biodentine™ material characteristics and clinical applications: a review of the literature. Eur Arch Paediatr Dent 2014;15:147- 58.
- 14.Gandolfi MG, Siboni F, Prati C. Chemical–physical properties of TheraCal, a novel light‐curable MTA‐ like material for pulp capping. Int Endod J 2012;45:571-9.
- 16.Katge AF, Devendra PP. Comparative analysis of 2 calcium silicate–based cements (Biodentine and Mineral Trioxide Aggregate) as direct pulp- capping agent in young permanent molars: a split mouth study. J Endod 2017;43:507-13.
- 17.Bogen G, Jay SK, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc 2008;139:305-15.
- 18.Bjørndal L, Fransson H, Bruun G, Markvart M, Kjældgaard M, Näsman P, et al. Randomized clinical trials on deep carious lesions: 5-year follow-up. J Dent Res 2017;96:747-53.
- 19.Jang Y, Song M, Yoo IS, Song Y, Roh B, Kim E. A randomized controlled study of the use of ProRoot mineral trioxide aggregate and Endocem as direct pulp capping materials: 3-month versus 1-year outcomes. J Endod 2015;41:1201-6.
- 20.Çalışkan MK, Güneri P. Prognostic factors in direct pulp capping with mineral trioxide aggregate or calcium hydroxide: 2-to 6-year follow-up. Clin Oral Investig 2017;21:357-67.
- 21.Vural UK, Kiremitci A, Gokalp S. Randomized clinical trial to evaluate MTA indirect pulp capping in deep caries lesions after 24-months. Oper Dent 2017;42:470-77.
- 22.Hegde S, Sowmya B, Mathew S,Bhandi SH, Nagaraja S, Dinesh K. Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth. J Conserv Dent 2017;20:91-95.
- 23.Parinyaprom N, Nirunsittirat A, Chuveera P, Lampang SN, Srisuwan T, Sastraruji T, et al. Outcomes of direct pulp capping by using either ProRoot mineral trioxide aggregate or Biodentine in permanent teeth with carious pulp exposure in 6-to 18-year-old patients: a randomized controlled trial. J Endod 2018;44:341-8.
- 24.Kundzina R, Stangvaltaite L, Eriksen H, Kerosuo E. Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. Int Endod J 2017;50:924-32.
- 25.Cengiz E, Yilmaz HG. Efficacy of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser irradiation combined with resin- based tricalcium silicate and calcium hydroxide on direct pulp capping: a randomized clinical trial. J Endod 2016;42:351-55.
- 26.Gandolfi MG, Siboni F, Prati C. Chemical– physical properties of TheraCal, a novel light‐ curable MTA‐like material for pulp capping. Int Endod J 2012;45:571-79.
- 27.Harkins SW, Chapman CR. Detection and decision factors in pain perception in young and elderly men. Pain 1976;2:253-64
- 28.Auschill TM, Arweiler NB, Hellwig E, Zamani-Alaei A, Sculean A. Success rate of direct pulp capping with calcium hydroxide. Schweiz Monatsschr Zahnmed 2003;113:946-52.
- 29.Willershausen B, Willershausen I, Ross A, Velikonja S, Kasaj A, Blettner M. Retrospective study on direct pulp capping with calcium hydroxide. Quintessence Int 2011;42:165-71.
- 30.Reuver J. 592 pulp cappings in a dental office--a clinical study (1966-1990). Dtsch Zahnarztl 1992;47:29-32.
- 31.Bogen G, Kim JS, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc 2008;139:305-15.
- 32.McWalter GM, El-Kafrawy AH, Mitchell DF Long-term study of pulp capping in monkeys with three agents. J Am Dent Assoc 1976;93:105-10.
- 33.Cox CF, Bergenholtz G, Fitzgerald M, Heys DR, Heys RJ, Avery JK, et al. Capping of the dental pulp mechanically exposed to the oral microflora–a 5 week observation of wound healing in the monkey. J Oral Pathol 1982;11:327-39