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Quantitative evaluation of leakage in roots filled retrogrately with different filled materials after apicoectomy Amaç: Endodontik tedavinin yeterli olmadığı ve sonrasında uygulanacak olan apikal rezeksiyon işleminin başarılı olabilmesi retrograd dolgunun

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Alt 23.12.10, 09:28
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Standart Quantitative evaluation of leakage in roots filled retrogrately with different filled materials after apicoectomy

Quantitative evaluation of leakage in roots filled retrogrately with different filled materials after apicoectomy
Amaç: Endodontik tedavinin yeterli olmadığı ve sonrasında uygulanacak olan apikal rezeksiyon işleminin başarılı olabilmesi retrograd dolgunun sızdırmazlığının çok iyi olması ile direk ilişkilidir. Bu çalışmada dört farklı retrograd dolgu materyalinin sızdırmazlık kabiliyetlerinin in vitro olarak değerlendirilmesi. (Amalgam, Komposit, Cam Ionomer Siman, Polyacid Modified Resin Composite "Compomer").
Gereç ve Yöntem: Bu çalışmada seksen adet çekilmiş maksiller ve mandibuler insan dişi kullanıldı. Dişlerin kanalları hazırlanıp doldurulduktan sonra, her bir kökün apikal 3mm'lik kısmı kesildi, 2 mm lik retrograd kaviteler açıldı ve dişler dört gruba ayrıldı. Grup 1 retrograd kaviteler "Amalgam" ile, Grup 2 retrograd kaviteler "AF bonding sistem ve ışınlı kompozit dolgu materyali" ile, Grup 3 retrograd kaviteler "Cam ionomer siman" ile, Grup 4 retrograd kaviteler ise "Polyacid modified resin composite "Compomer" ile dolduruldu. Test edilen materyallerin sızdırmazlığı "sıvı filtrasyon metodu" ile birinci ve yedinci günde ölçülerek değerlendirildi.
Sonuç: Ölçümler sonucu elde edilen veriler "Two Way ANOVA" testi ile analiz edildi. Sonuç olarak rezin materyallerinin, amalgam grubuna göre kıyaslandığında daha güçlü sızdırmazlık gösterdiği görüldü
Apicoectomy in combination with retrograde filling is a common treatment for periapically infected teeth. The single most important factor determining the success of an apicoectomy is the efficiency of the apical seal. The apical seal inhibits leakage of residual irritants from the root canal into the periradicular tissues. Root-end fillings should prevent egress of potentional contaminants and irritants into the periradicular tissues and biocompatible surgery is not infallible and poor apical seal is cited as a cause of failure.
Altough various materials have been recommended for use as retrograde fillings, no material to date has produced a perfect seal and amalgam remains the most widely used retrofilling material (1). However, with the advent of developments in adhesive dentistry, new bonding agents and composite resins were introduced to the dental commity with improved adhesive properties. Composite resins and dentine bonding agents have been suggested as retrograde filling material by Chong et al (2). A new class of restorative materials is the compomers, which are a mixture of composite resins and glass ionomer cements. These materials are becoming popular in restorative dentistry, because they possess the strenght and esthetic qualities of the composite restorative, while bonding without need for acid-etching to dentine. In addition they release fluoride after placement to inhibit caries, like the glass ionomer cements. These hybrits are easier to place than the older materials due to their one- component, no-mix direct delivery system. Significantly, they exhibit biocompatability in that gingival tissues appear to adhere to them, resulting in a postoperative gain in clinical attachment when placed subgingivally (3). This feature may allow fibroblasts of the periodontal ligament to attach to and reform around a root apex in which a compomer root-end filling is placed (4).
The aim of this study was to compare apical fluid penetration with four different retrofilling materials (amalgam, composite, glass-ionomer cements and polyacid modified resin composite "Compomer") using a fluid filtration method previously described and modified by Pashley et al (5).
MATERIAL AND METHODS
Eighty extracted single-rooted sound human teeth consisting of incisors, canines and premolars were collected and stored in tap-water at room temperature. All calculus and periodontal remmants were carefully removed with hand scaling instru-
ments. In attempt to standardize the length of canal involved in the experiment, similar root segments were used with a length of approximately 17 mm. An access cavity was prepared through the crown into the pulp space. The pulp of each tooth was removed with a barded broach. Canal patency was determined by passing a size 10 K-file through the apical foramen. Working lengths were established 1.0 mm short of the apical foramen, and instrumented using ProFile .04 taper Series 29 rotary instruments (Tulsa Dental Products, Tulsa, OK, USA). The same operator instrumented all teeth to the same size. Instrumentation was performed according to the manufacturer's recommendations. ProFile instruments were used in crown-down movements with the Tri-Auto handpiece with 350 rpm clockwise rotations. The canals were enlarged to a diameter of 0.465 mm (#7) at the apical stop, with patency assured by periodic recapitulation with a size 10 K-file. During instrumentation, canals were irrigated with 1 ml of 5.25% NaOCl after each file.
All the teeth were subsequently apicected with an ISO size 012 plain cut tungsten carbide bur at high speed (300,000 rpm) with water coolant. About 3 mm of the root apex was removed and the root surface was bevelled labially at approximately 45 (to the long axis of the tooth). All the apicected root faces were of approximately similar dimensions (buccal-Ungual: 3 mm± 0.1, mesial- distal: 3 mm±0.1 mm).
The teeth were then divided into four groups of 20 teeth each, Group 1: Retograde cavities were sealed with amalgam (Cavex, Holland), Group 2 were sealed with ABF bonding system (Kuraray Co., Inc., Japan) and a light-cured composite, Group 3 were sealed with glass-ionomer cements (Ketac-Cam ESPE, Germany), Group 4 were sealed with a compomer restorative material (Dyract, Dentsply, Germany) (Table-1). Materials were prepared according to the manufacturer's directions and placed into the retrograde cavities .
The access cavities were then filled with Cavit-G (ESPE, Seefeld, Germany) and the teeth were left in saline solution for 1 week at 37°C. Each tooth was then placed into a device designed to measure leakage by fluid transport as described previously by Pashley et al and as modified by Wu et al for endodontic leakage studies (5, 6). Briefly the root sections were connected in an 18-gauge stainless steel tube as shown in Figure 1.
The sealing qualities of the two test materials in smear layer absence or presence was measured by following the progress of a tiny air bubble traveling within a 25 ]iL micropipette. All pipettes, syringes and the plastic tubes at apical sides of the specimens were filled with distilled water. The micropipette was connected to the plastic tube at the outlet side of the specimen.
1.JPG
Water was sucked back with the microsyringe for approximately 2 mm, in the other end of the micropipette. In this way, an air bubble created in the micropipette and the air bubble was adjusted to a suitable position with the syringe. Finally, an 02 from pressure tank of 3 psi from the apical side was applied and forced the water through the voids along the root canal filling, displacing the air bubble in the capillary tube by transport of the water. The volume of the fluid transport was measured by observing the movement of this air bubble. Displacement of this air bubble was recorded as the fluid transport and results were expressed in pL.min-1. The fluid flow rate through the 18 gauge needle in the root canal was measured by weighting the amount of water that could flow through the needle in one minute (1.850 g/min at 239 cm H20 or 15.535 UL/min/239 cm H20 or 113 jiL min-1 cm H20-1). Measurements of fluid movement were made at 2 minute intervals for 8 minutes, which were then averaged.
Apical leakage based on the quantitative was noted in all specimens. The results were recorded and then the data was subjected to statistical analysis using two way ANOVA test.

Hasan KÜÇCİKKOLBAŞI*, Hanife ATAOĞLÜ*, Sema BELLI**
* Selcuk University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Konya ** Selcuk University Faculty of Dentistry, Department of Endodontics, Konya 18
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Dosya tipi: pdf 18-21.pdf (2,58 MB (Megabyte), 3x kez indirilmiştir)
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apicoectomy, evaluation, filled, leakage, materials, quantitative, retrogrately, roots

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