KANAL DOLGU TEKNİKLERİNİN VE KANAL DOLGU PATLARININ APİKALDEN TAŞAN DEBRİS VE KANAL DOLGUSUNUN SÖKÜLEBİLİRLİĞİNDEKİ ROLLERİ

Abstract

In case of initial root canal treatment fails, the next step of treatment might be orthograde retreatment of the root canal if the tooth can be restored and is periodontally healthy. Inadequate removal of filling materials may affect treatment success via preventing contact of irrigation solutions with persistent microorganisms. Furthermore, during retreatment, canal debris may be extruded apically and cause postoperative pain. The aim of this study is to evaluate the amount of apically extruded debris and to determine the remaining filling material on the root canal walls by micro-CT following the root canal retreatment of root canals filled with different obturation techniques (single cone technique, warm obturation technique) and the different root canal sealers (bioceramic sealer, epoxy resin-based sealer). In the present study, 60 single rooted human premolar teeth were used. All the teeth were prepared with the ProTaper Gold system up to the ProTaper Gold F4 file and after the chemomechanical preparations were completed, the samples were divided into 4 groups: SOG-ER: AH Plus (Dentsply) canal sealer and single cone technique, SOG-BS: Bioceramic canal sealer (Sure-Seal Root, Sure Dent) and single cone technique, SIG-ER: AH Plus canal sealer and Calamus (Dentsply) thermoplastic injection technique, SIG-BS: Bioceramic canal sealer (Sure-Seal Root, Sure Dent) and Calamus thermoplastic injection technique. The teeth were placed to eppendorf tubes and irrigation was completed using a total of 5 ml distilled water during root canal retreatment. The tubes were kept in an incubator at 37 ⁰C for 14 days in order to evaporate the water in the tubes and to measure only the dry debris weight. Following the removal of the root canal filling, the samples were removed from the eppendorf tubes and the teeth were scanned with a micro-CT device in order to analyze remaining filling materials. Extrusion of debris was seen in all groups. Regardless of the method used, it was observed that the bioceramic-based sealer increased the amount of extruded debris compared to the epoxy resin-based sealer. The heaviest debris was observed in the SIG-BS group, the lightest debris was observed in the SOG-ER group (p<0.05). The percentage of remaining filling materials was the highest in the SOG-BS and was the lowest in the SIG-ER group (p>0.05). No correlation was observed among the groups in terms of extruded debris and retreatability. Regardless of the obturation technique and type of sealer used, debris extrusion was observed during the retreatment process in each group, and the canal filling material could not be completely removed from the canal in any group. It was observed that filling techniques played a role on the debris extrusion, and sealers played a role on the percentage of remaining filling materials in the canal. Further studies are needed with these two variables (extrusion-retreatability) which no correlation could be found.