Efikasnost različitih rotirajućih sistema u uklanjanju dva opturaciona materijala pri endodontskom retretmanu
Sažetak
Apstrakt
Uvod/Cilj. U cilju postizanja dobrih rezultata u endodontskom retretmanu, neophodno je omogućiti zadovoljavajuće uklanjanje opturacionog materijala i adekvatan debridman kanala korena zuba. Cilj ove in vitro studije bio je evaluacija efikasnosti tri sistema rotirajućih instrumenata u uklanjanju gutaperke/AH Plus silera i RealSeal SE sistema tokom retretmana, primenom skenirajuće elektronske mikroskopije. Metode. Kanali korenova 72 sveže ekstrahirana donja centralna inciziva su preparisani primenom rotirajućih iRaCe NiTi instrumenata do veličine #30. Zubi su nasumično podeljeni u 6 grupa od po 12 uzoraka. Ukupno 36 zuba (grupe 1, 2 i 3) opturisani su gutaperkom sa AH Plus silerom, a preostalih 36 zuba (grupe 4, 5 i 6) RealSeal SE sistemom, primenom tehnike hladne lateralne kondenzacije. U grupama 1 i 4 retretman je obavljen primenom ProFile Sistema, u grupama 2 i 5 primenom ProTaper Universal Retreatment sistema, a u grupama 3 i 6 primenom D-RaCe Sistema. Posle retretmana zubi su presečeni longitudinalno na polovine a efikasnost metoda retretmana ocenjivana je pomoću skenirajuće elektronske mikroskopije. Upoređivanje tri parametra (prisustvo razmaznog sloja, debris od ostataka opturacionog materiajala i iregularnost površine) obavljeno je pomoću prethodno definisane skale vrednosti. Ova tri parametra su ocenjivana u koronarnoj, srednjoj i apikalnoj trećini korena zuba. Statistička analiza je obavljena primenom Kruskal-Wallis testa sa Bonferroni post-hoc testom. Rezultati. U uzorcima opturisanim AH Plus/gutaperkom uklanjanje debrisa bilo je statistički značajno bolje primenom D-RaCe i ProTaper sistema u odnosu na ProFile sistem u apikalnoj trećini (p < 0.05). Utvrđeno je manje iregularnosti površine dentina kada je korišćen ProTaper system u poređenju sa ProFile sistemom (p = 0.0139). Kod uzoraka opturisanih RealSeal SE sistemom nisu utvrđene statistički značajne razlike između ispitivanih metoda retretmana. Zaključak. Ni jedna od tehnika instrumentacije nije omogućila kompletno uklanjanje opturacionog materijala iz kanala korena zuba. Sve ispitivane tehnike retretmana su bile manje efikasne u apikalnoj trećini kanala korena, nezavisno od vrste opturacionog materijala.
Reference
REFERENCES
Iriboz E, Sazak ÖH. Comparison of ProTaper and Mtwo re-treatment systems in the removal of resin-based root canal ob-turation materials during retreatment. Aust Endod J 2014; 40(1): 6–11.
Schirrmeister JF, Wrbas K, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha re-moval in root canal retreatment. J Endod 2006; 32(5): 469–72.
Shipper G, Ørstavik D, Teixeira FB, Trope M. An evaluation of microbial leakage in roots filled with a thermoplastic synthetic polymer-based root canal filling material (Resilon). J Endod 2004; 30(5): 342–7.
Cunha RS, De Martin AS, Barros PP, Silva FM, Jacinto RC, Bueno CE. In vitro evaluation of the cleansing working time and analysis of the amount of gutta-percha or Resilon remnants in the root canal walls after instrumentation for endodontic retreatment. J Endod 2007; 33(12): 1426–8.
Melih I, Jakovljević A, Popović M, Pešić D. Comparative evaluation of sealing ability of different obturation materials. Srp Arh Celok Lek 2010; 138(5–6): 287–91. (Serbian)
Marfisi K, Mercade M, Plotino G, Duran-Sindreu F, Bueno R, Roig M. Efficacy of three different rotary files to remove gutta-percha and Resilon from root canals. Int Endod J 2010; 43(11): 1022–8.
Ezzie E, Fleury A, Solomon E, Spears R, He J. Efficacy of re-treatment techniques for a resin-based root canal obturation material. J Endod 2006; 32(4): 341–4.
Dadresanfar B, Iranmanesh M, Mohebbi P, Mehrvarzfar P, Vatanpour M. Efficacy of Two Rotary NiTi Instruments in Removal of Resilon/Epiphany Obturants. Iran Endod J 2012; 7(4): 183–8.
Oyama KO, Siqueira EL, Santos M. In Vitro Study of Effect of Solvent on Root Canal Retreatment. Braz Dent J 2002; 13(3): 208–11.
Horvath SD, Altenburger MJ, Naumann M, Wolkewitz M, Schirrmeister JF. Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: A scanning electron microscopic study. Int Endod J 2009; 42(11): 1032–8.
Helvacioglu-Yigit D, Yilmaz A, Kiziltas-Sendur G, Aslan OS, Abbott PV. Efficacy of reciprocating and rotary systems for removing root filling material: A micro-computed tomography study. Scanning 2014; 36: 576–81.
Rios Mde A, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, et al. Efficacy of 2 reciprocating systems compared with a rotary retreatment system for gutta-percha removal. J Endod 2014; 40(4): 543–6.
de Mello Junior JE, Cunha RS, Bueno CE, Zuolo ML. Re-treatment efficacy of gutta-percha removal using a clinical microscope and ultrasonic instruments: part I-an ex vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(1): e59–62.
Pirani C, Pelliccioni GA, Marchionni S, Montebugnoli L, Piana G, Prati C. Effectiveness of three different retreatment techniques in canals filled with compacted gutta-percha or Thermafil: a scanning electron microscope study. J Endod 2009; 35(10): 1433–40.
Anjo T, Ebihara A, Takeda A, Takashina M, Sunakawa M, Suda H. Removal of two types of root canal filling material using pulsed Nd: YAG laser irradiation. Photomed Laser Surg 2004; 22(6): 470–6.
Keleş A, Arslan H, Kamalak A, Akçay M, Sousa-Neto MD, Ver-siani MA. Removal of filling materials from oval-shaped canals using laser irradiation: A micro-computed tomographic study. J Endod 2015; 41(2): 219–24.
Keles A, Kamalak A, Keskin C, Akçay M, Uzun İ. The efficacy of laser, ultrasound and self-adjustable file in removing smear layer debris from oval root canals following retreatment: A scanning electron microscopy study. Aust Endod J 2016; 42(3): 104–11.
Rödig T, Hausdörfer T, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals - a micro-computed tomography study. Int Endod J 2012; 45(6): 580–9.
Bernardes RA, Duarte MA, Vivan RR, Alcalde MP, Vasconcelos BC, Bramante CM. Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. Int Endod J 2015. doi: 10.1111/iej.12522.
Rödig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J 2014; 47(10): 942–8.
Zuolo AS, Mello JE, Cunha RS, Zuolo ML, Bueno CE. Efficacy of reciprocating and rotary techniques for removing filling ma-terial during root canal retreatment. Int Endod J 2013; 46(10): 947–53.
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 mate-rials. J Endod 2008; 34(4): 466–9.
Pešić D, Melih I, Kolak V, Nikitović A, Jakovljević A. Evaluation of apically extruded debris during removal of gutta-percha and resilon using different instrumentation techniques. Vojnosanit Pregl 2018; 75(1): 56–61.
Foschi F, Nucci C, Montebugnoli L, Marchionni S, Breschi L, Malagnino VA, et al. SEM evaluation of canal wall dentine following use of Mtwo and ProTaper NiTi rotary instruments. Int Endod J 2004; 37(12): 832–9.
Prati C, Foschi F, Nucci C, Montebugnoli L, Marchionni S. Appear-ance of the root canal walls after preparation with NiTi rotary instruments: A comparative SEM investigation. Clin Oral In-vest 2004; 8(2): 102–10.
Simsek N, Ahmetoglu F, Keles A, Bulut ET, Er K. 3D analysis of D-RaCe and self-adjusting file in removing filling materials from curved root canals instrumented and filled with different techniques. ScientificWorldJournal 2014; 2014: 836513.
Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: A review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94(6): 658–66.
Fenoul G, Meless GD, Pérez F. The efficacy of R-Endo rotary NiTi and stainless-steel hand instruments to remove gutta-percha and Resilon. Int Endod J 2010; 43(2): 135–41.
Zarei M, Shahrami F, Vatanpour M. Comparison between gutta-percha and Resilon retreatment. J Oral Sci 2009; 51(2): 181–5.
Nair PN, Sjögren U, Krey G, Sundqvist G. Therapy-resistant for-eign body giant cell granuloma at the periapex of a root-filled human tooth. J Endod 1990; 16(12): 589–95.
Marques SB, Baratto-Filho F, Leonardi DP, Henrique BA, Volpato L, Branco BF. Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material. Int Endod J 2012; 45(10): 927–32.
Bramante CM, Fidelis NS, Assumpção TS, Bernardineli N, Garcia RB, Bramante AS, et al. Heat release, time required, and clean-ing ability of MTwo R and ProTaper universal retreatment systems in the removal of filling material. J Endod 2010; 36(11): 1870–3.
Mickel AK, Chogle S, Liddle J, Huffaker K, Jones JJ. The role of apical size determination and enlargement in the reduction of intracanal bacteria. J Endod 2007; 33(1): 21–3.