Melek AKMAN, Arslan TERLEMEZ, Makbule Bilge AKBULUT, Hale ARI AYDINBELGE

Modifiye Üçlü Antibiyotik Patının Uzaklaştırılmasında Fotonla İndüklenmiş Fotoakustik Dalgalanma ile Farklı İrrigasyon Aktivasyon Rejimlerinin Kombinasyonunun Karşılaştırılması

Amaç: Bu çalışmanın amacı, kök kanallarından modifiye üçlü antibiyotik patının (mTAP) çıkarılmasında foton kaynaklı fotoakustik dalgalanma (PIPS) tekniği ile farklı irrigasyon aktivasyon rejimlerinin kombinasyonunun etkinliğini karşılaştırmaktır. Gereç ve Yöntemler: Yüz beş adet çekilmiş insan mandibular-premolar dişler ProTaper döner eğe kullanarak prepare edildi. Kök kanalları mTAP medikamenti ile dolduruldu ve 4 hafta sonra kökler kullanılan irrigasyon rejimlerine göre rastgele 7 gruba (n=15) ayrıldı: Self-Adjusting File (SAF), Pasif-Ultrasonik-İrrigasyon (PUI) , EndoAktivatör (EA), SAF+EA, SAF+PUI, PUI+EA, PIPS. 3 dişte mTAP kaldırılmadı (pozitif kontrol) ve diğer 3 diş mTAP ile doldurulmadı (negatif kontrol). Kökler uzunlamasına ikiye ayrıldı ve kalan mTAP miktarı, 4 dereceli bir skorlama sistemi kullanılarak 20x büyütme ile değerlendirildi. Veriler Kruskal-Wallis ve Mann-Whitney U testleri kullanılarak değerlendirildi. Bulgular: Tüm deney grupları arasında istatistiksel olarak anlamlı farklılık tespit edildi. PIPS, SAF, SAF+EA ve SAF+PUI, mTAP'yi kök kanalından çıkarmada PUI ve PUI+EA'dan önemli ölçüde daha iyi performans gösterdi (P=0.000). EA orta etkinlik gösterdi. Apikal ve orta üçte birlik kısımda PUI ve PUI+EA ve koronal üçte birlik kısımda PUI önemli ölçüde daha kötü performans gösterdi (P<0.05). Sonuç: Genel olarak, antibiyotik patlarını kök kanallarından tamamen çıkarmak zordur. Yalnızca PIPS tekniği, apikal üçte birlik kısımda mTAP'ın %100'ünü çıkardı.

Anahtar Kelimeler:

Endoaktivatör, Foton kaynaklı fotoakustik dalgalanma, self-adjusting file, ultrasonik

Comparison of the Photon-initiated Photoacoustic Streaming Technique and a Combination of Different Irrigation Activation Regimens on the Removal of Modified Triple Antibiotic Paste

Background: The aim of this study was to compare the efficacy of the combination of different irrigation activation regimens, and the photon-induced photoacoustic streaming (PIPS) technique, in the removal of modified triple antibiotic paste (mTAP) from the root canals. Methods: One-hundred and five extracted human mandibular-premolars were prepared using ProTaper Rotary-Files. The root canals were filled with mTAP medicament, and after 4 weeks, the roots were randomly assigned to 7 groups (n=15) according to the irrigation regimens used: Self-Adjusting File (SAF), Passive-Ultrasonic-Irrigation (PUI), EndoActivator (EA), SAF+EA, SAF+PUI, PUI+EA, PIPS. In 3 teeth, the mTAP was not removed (positive-controls), and another 3 teeth were not filled with mTAP (negative-controls). The roots were sectioned and the amount of remaining medicament was evaluated upon 20x magnification, using a 4-grade scoring system. The data was evaluated using the Kruskal-Wallis and Mann-Whitney U tests. Results: There were statistically significant differences among all of the experimental groups. The PIPS, SAF, SAF+EA, and the SAF+PUI showed significantly better performances than the PUI and the PUI+EA in removing the mTAP from the root canal (P=0.000). The EA showed mid-effectiveness. At the apical and middle-third, the PUI and the PUI+EA, and at the coronal-third, the PUI showed significantly worse performances (P<0.05). Conclusions: Overall, it is difficult to completely remove antibiotic pastes from root canals. Only the PIPS technique removed 100% of the mTAP at the apical-third.

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