Farklı İrrigasyon Solüsyonları Ve İrrigasyon Tekniklerinin Kanal İçi Medikamentlerin Kök Kanalından Uzaklaştırılması Üzerine Etkisi

Abstract

İLGEN S. Efficacy of Various Irrigation Solutions and Irrigation Techniques on the Removal of Intracanal Medicaments from the Root Canal. Hacettepe University Faculty of Dentistry, Department of Endodontics Specialization Thesis, Ankara, 2023 Purpose: The aim of our study is to comparatively examine the removal of double antibiotic paste (DAP) and calcium hydroxide paste [Ca(OH)2] used in regenerative endodontic treatments from root canals with various final irrigation solutions (17% EDTA, 17% EDTA + 0.008% BAK, 10% glycolic acid and 70% ethanol) and irrigation methods (traditional needle irrigation, sonic activation and passive ultrasonic irrigation). Materials and methods: 252 human teeth with single root canal were used in the study. The crowns of the teeth were cut from the enamel-cement area and decoronized. In order to imitate immature permanent tooth roots, the remaining root structures were enlarged with the ProTaper Universal rotary file system (F5) and the apical 3 mm parts were removed to eliminate apical deltas and create the immature root form. To compare the amount of removal of medicaments, the samples were first divided into two main groups: tooth roots treated with Ca(OH)2 or DAP. Then, each group was divided into 4 subgroups and the groups of final irrigation solutions to be applied were created. In order to evaluate the effectiveness of irrigation methods, the subgroups were divided into 3 different groups and a total of 24 working groups (n = 10) were created. Additionally, 3 positive and 3 negative control samples were prepared for the Ca(OH)2 and DAP groups. Intracanal medicaments were removed with the specified solutions and irrigation techniques 2 weeks after their placement in the root canals. To evaluate the medicament residues, the samples were examined by two physicians under 25x magnification with the help of a stereomicroscope and photographed with a digital camera connected to the microscope, and the images were transferred to the computer environment. Two observers independently evaluated and scored the stereomicroscope images of the teeth three times at 1-week intervals with the image analysis program. Interobserver agreement was determined by Cohen's kappa test. Comparisons between two independent groups were made with the Mann-Whitney U test, and comparisons between more than two independent groups were made with the Kruskal Wallis test. Results: In both intracanal medicament groups, the lowest residue scores were seen in 17% EDTA, 17% EDTA + 0.008% BAK solutions (p<0.05). The highest residue scores were seen in the 10% glycolic acid solution in both intracanal medicament groups (p<0.05). On the other hand, it was observed that different irrigation methods had similar effectiveness in removing medicaments (p>0.05).