Betül ÖZÇOPUR, Melek AKMAN, Sema HAKKI, Sema BELLİ

Perforasyon tamir materyallerinin sızıntı ve kalitesi: İntrakoronal ve retrograd tekniklerin karşılaştırılması

Amaç: Bu in vitro çalışmanın amacı, perforasyon tamir materyallerinin, perforasyon bölgesine ortograd ya da retrograd yerleştirildiğinde, sızıntı ve kalitesini değerlendirmektir. Gereç ve Yöntemler: Çekilmiş insan molar dişlerin mesial ve distal kök yüzeylerinde, dişin uzun aksına 45 derecelik açıyla elmas bir frez ile kasten perforasyonlar oluşturuldu. Mesial perforasyonlar intrakoronal olarak şu materyaller kullanılarak tamir edildi: IRM (Dentsply), amalgam (Dentsply), Dyract (Dentsply), SuperBond C&B (Sun Medical) and MTA (Dentsply). Siman ile giriş kavitesi doldurulduktan sonra distal perforasyonlar aynı materyaller ile retrograd olarak tamir edildi. Dişler %100 nemli ortamda 24 saat saklandı. Perforasyon bölgeleri 24 saat %2’lik metilen mavisinde bekletildi. Dişler kesilerek, 20x ve 40x büyütme ile stereomikroskop altında incelendi ve boya penetrasyonuna göre taşmış, yeterli ve yetersiz olarak skorlandı. Bulgular: Veriler Kruskal-Wallis ve MannWhitney U-testleri ile analiz edildi. Restorasyon teknikleri arasında önemli derecede fark bulundu (p < 0.05). Tüm materyallerde retrograd teknik kullanıldığı zaman daha az sızıntı gözlendi (p < 0.05). Giriş kavitesi boyunca perforasyonun tamiri, %86 taşmış ya da yetersiz bulundu. Retrograd olarak uygulandığı zaman IRM %80, MTA %60 oranında sızıntı olmadan yeterli bulundu. Sonuç: Retrograd teknik kullanarak perforasyonların tamiri, kullanılan materyalin etkisi olmaksızın yeterli restorasyonun sayısı önemli derecede arttı. IRM retrograd uygulandığı zaman MTA’yı takiben en iyi kapamayı sağladı.

Anahtar Kelimeler:

MTA, perforasyon, sızıntı

Quality and leakage of perforation repair-materials: A comparison of intracoronal and retrograde techniques

Background: The objective of this in vitro study was to evaluate the quality and leakage of repair materials when perforation sites were challenged from an orthograde or retrograde direction.Methods: Intentional perforations were created on the mesial and distal root surfaces of the extracted human molar teeth (below the CEJ) using a diamond bur at a 45 degree angle to the long axis. Mesial perforations were repaired intracoronally using the following materials (n=15): IRM (Dentsply), amalgam (Dentsply), Dyract (Dentsply), SuperBond C&B (Sun Medical) and MTA (Dentsply). After filling the access cavities with cement, distal perforations were repaired retrogradely using the same materials. The teeth were kept at humid conditions (100%, 24hrs), the perforation sites were stained with 2%methylene blue (24hrs), sectioned and examined under a stereomicroscope at 20x and 40x magnifications and scored as extruded, insufficient or adequate in combination with the dye penetration.Results: The data was statistically analyzed (Kruskal-Wallis and Mann-Whitney U-tests). A significant difference was found among the restoration techniques (p < 0.05). All the materials showed less leakage when used retrogradely (p < 0.05). Repair of the perforation through the access cavity resulted in 86% extruded or insufficient restorations with leakage. IRM restoration showed 80% and MTA showed 60% adequate restoration without leakage when applied retrogradely.Conclusion: Repair of the perforations using the retrograde technique has significantly increased the number of the adequate restorations regardless the effect of the material factor. IRM showed the best sealing followed by MTA when applied retrogradely.

Keywords:

Leakage, MTA, perforation,

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Alhadainy H, Himel V, 1993. Comparative study of the sealing ability of light-cured versus chemically cured materials placed into furcation perforations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 76, 338-342.
Balla R, LoMonaco CJ, Skribner J, Lin LM, 1991. Histological study of furcation perforatios treated with tricalcium phosphate, hydroxylapatite, amalgam and, a life. J Endod, 17, 234-238.
Benenati F, Roane J, Biggs JT, Simon J, 1986. Recall evaluation of iatrogenic root perforations repaired with amalgam and gutta percha J Endod, 12, 161-166.
Blaney T, Peters D, Scherstrom J, Bernier W, 1981. Marginal sealing quality of IRM and Cavit as assessed by microbial penetration. J Endod, 7, 453-457.
Bouillaguet S, Troesch S, Wataha JC, Krejci I, Meyer JM, Pashley DH, 2003. Microtensile bond strength between adhesive cements and root canal dentin. Dent Mater, 19, 199-205.
Coomaraswamy KS, Lumley PJ, Hofmann MP, 2007. Effect of bismuth oxide radioopacifier content on the material properties of an endodontic Portland cement-based (MTA-like) system. J Endod, 33, 295-298.
De-Deus G, Reis C, Brandao C, Fidel S, Fidel RA, 2007. The ability of portland cement, MTA, MTA Bio to prevent through-and-through fluid movement in repaired furcal perforations. J Endod, 33, 1374-1377.
Dorn SO, Gartner AH, 1990. Retrograde filling materials: a retrospective success-failure study of amalgam, EBA and IRM. J Endod, 16, 391-393.
Ferraz CCR, Teixeira FB, Leite APP, Souza Filho FJ, 1999. In vitro assessment of the ability of four barrier materials to prevent coronal microleakage. J Endod, 18, 25-302.
Frank A, Weine FS, 1973. Nonsurgical theraphy for the perforative defect of lateral resorption. J Am Dent Assoc, 87, 863-888.
Frank LA, Glick DH, Patterson SS, Weine FS, 1992. Long term evaluation of surgically placed amalgam fillings. J Endod, 18, 391-398.
Fuss Z, Trope M, 1996. Root perforations: classification and treatment choices based on prognostic factors. Endod Dent Travmatol, 12, 255-264.
Gartner A H, Dorn S O, 1992. Advances in endodontic surgery. Dent Clin North Am, 36, 357-378.