Tek seansta kök kanal tedavisi uygulamalarında iki farklı kök kanal patının postoperatif ağrı üzerindeki etkisinin değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızın amacı vital pulpaya sahip, derin çürük nedeniyle asemptomatik geri dönüşümsüz pulpitis tanısı konmuş, alt çene molar dişlere tek seansta kanal tedavisi uygularken kullanılan MTA bazlı biyoseramik kanal patı olan MTA Fillapex ve rezin esaslı AH Plus kanal patlarının postoperatif ağrıya ve analjezik kullanımına etkisini değerlendirmek ve karşılaştırmaktır. Bu çalışmada, asemptomatik geri dönüşümsüz pulpitis tanısı konan vital pulpalı toplam 82 mandibular birinci ve ikinci molar diş, MTA Fillapex veya AH Plus kök kanal patları kullanılmak üzere rastgele iki gruba ayrıldı. Kanal tedavileri tek seansta ve tek bir hekim tarafından uygulandı. Dahil edilen tüm dişlerde çürük uzaklaştırıldıktan sonra endodontik giriş kaviteleri hazırlandı. Kök kanallarının çalışma uzunlukları apeks bulucu kullanılarak belirlendi ve dijital periapikal radyografilerle doğrulandı. Her iki grupta da kanal şekillendirmesi için WaveOne Gold kanal eğeleri kullanıldı. Son irrigasyon 5 ml %17 etilen diamin tetraasetik asit (EDTA), 5 ml %2,5'luk sodyum hipoklorit (NaOCl) ve ardından distile su ile yapıldı. Kök kanalları steril kağıt konlarla kurutulduktan sonra şekillendirme tekniğinin kendi güta-perka konları ile dolduruldu. Kanal patı olarak birinci grupta MTA Fillapex, ikinci grupta AH Plus kullanıldı. Koroner restorasyonlar kompozit rezin ile tamamlandı. Kanal tedavisinden 6, 12, 24, 48, 72 saat sonra, 4, 5, 6, 7 ve 30. günlerde postoperatif ağrı Sayısal Derecelendirme Skalası (NRS) ile ölçüldü ve hastalar işlem sırasında kullandıkları analjezik sayısını kaydetmeleri konusunda bilgilendirildi. Çalışmaya öncelikle 82 hasta dahil edildi, ancak 7 hasta takip protokolüne uymadığı için çalışma dışı bırakıldı. Geriye kalan 75 hasta MTA Fillapex grubunda 38 hasta ve AH Plus grubunda 37 hasta olmak üzere iki gruba ayrıldı. Tüm zaman noktalarında postoperatif ağrı insidansı ve yoğunluğu açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Çalışmada değerlendirilen gruplar arasında analjezik alımı açısından istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Hastaların yaşları ile postoperatif ağrı bulguları arasında anlamlı bir ilişki bulunmazken (p>0,05) cinsiyet grupları arasında istatistiksel olarak anlamlı fark vardı ve kadınlarda postoperatif ağrı daha fazlaydı (p<0,05). Bu çalışmada asemptomatik vital molar dişlerde MTA Fillapex ve AH Plus kanal patları ile postoperatif ağrı sıklığı ve şiddetinin benzer olduğu görüldü. Ek olarak, gruplar arasında analjezik kullanım sayısında istatistiksel olarak anlamlı bir fark yoktu. Bu bulgulara göre, vital pulpalı asemptomatik alt çene molar dişlerin tek seansta kanal tedavilerinde, MTA bazlı biyoseramik patlar rezin esaslı patlara benzer şekilde günlük endodontik uygulamalarda postoperatif ağrı açısından güvenle kullanılabilir
The aim of this prospective study was to evaluate and compare the effect of MTA-based bioceramic and resin-based root canal sealers on the occurence of postoperative pain in asymptomatic vital molar teeth in single-visit root canal treatment. In the present study, a total of 82 asymptomatic mandibular first and second molar teeth with vital pulp, diagnosed as asymptomatic irreversible pulpitis, were randomly assigned to two groups; MTA Fillapex or AH Plus sealer. Root canal treatments were performed by one operator in single-visit. Access cavities were prepared after caries removal in all included teeth. Working lengths of the root canals were determined using an apex locater and it was confirmed with digital periapical radiographs. WaveOne Gold instruments were used for root canal preperations in both groups. Final irrigation was performed with 5 ml 17% ethylene diamine tetraacetic acid (EDTA), 5 ml 2.5% NaOCl and then distilled water. Root canals were dried with sterile paper points and filled with the own gutta-percha points of preperation technique. MTA Fillapex was used in the first group and AH Plus was used in the second group as a root canal sealer. Coronary restorations were completed with composite resin. Postoperative pain at 6, 12, 24, 48, 72 hours, 4, 5, 6, 7 and 30 days after root canal treatment was measured with Numerical Rating Scale (NRS) and patients were informed to record the number of analgesics they used during these time periods. Eighty-two patients were primarily involved in the study, but 7 patients did not comply with the follow-up protocol and were excluded. Seventy-five patients were available for recalls; 38 patients in MTA Fillapex group and 37 patients in AH Plus group. There was no statistically significant difference between the groups in terms of postoperative pain incidence and intensity at all time points (p> 0,05). No statistically significant difference was found among the groups assessed in the study in terms of analgesic intake (p> 0,05). There was no correlation between the age and postoperative pain of the patients (p>0,05). There was statistically significant difference between the gender groups and was higher in women (p<0,05). In the present study, postoperative pain incidence and intensity with MTA Fillapex and AH Plus sealers were similar in asymptomatic vital molar teeth. Additionally, there was no statistically significant difference in the number of analgesic intake between the groups. With these findings, MTA based bioceramic sealers can be used as resin based sealers in daily endodontic practice with respect to postoperative pain in single-visit root canal treatment's of vital mandibular molar teeth with asymptomatic irreversible pulpitis.
The aim of this prospective study was to evaluate and compare the effect of MTA-based bioceramic and resin-based root canal sealers on the occurence of postoperative pain in asymptomatic vital molar teeth in single-visit root canal treatment. In the present study, a total of 82 asymptomatic mandibular first and second molar teeth with vital pulp, diagnosed as asymptomatic irreversible pulpitis, were randomly assigned to two groups; MTA Fillapex or AH Plus sealer. Root canal treatments were performed by one operator in single-visit. Access cavities were prepared after caries removal in all included teeth. Working lengths of the root canals were determined using an apex locater and it was confirmed with digital periapical radiographs. WaveOne Gold instruments were used for root canal preperations in both groups. Final irrigation was performed with 5 ml 17% ethylene diamine tetraacetic acid (EDTA), 5 ml 2.5% NaOCl and then distilled water. Root canals were dried with sterile paper points and filled with the own gutta-percha points of preperation technique. MTA Fillapex was used in the first group and AH Plus was used in the second group as a root canal sealer. Coronary restorations were completed with composite resin. Postoperative pain at 6, 12, 24, 48, 72 hours, 4, 5, 6, 7 and 30 days after root canal treatment was measured with Numerical Rating Scale (NRS) and patients were informed to record the number of analgesics they used during these time periods. Eighty-two patients were primarily involved in the study, but 7 patients did not comply with the follow-up protocol and were excluded. Seventy-five patients were available for recalls; 38 patients in MTA Fillapex group and 37 patients in AH Plus group. There was no statistically significant difference between the groups in terms of postoperative pain incidence and intensity at all time points (p> 0,05). No statistically significant difference was found among the groups assessed in the study in terms of analgesic intake (p> 0,05). There was no correlation between the age and postoperative pain of the patients (p>0,05). There was statistically significant difference between the gender groups and was higher in women (p<0,05). In the present study, postoperative pain incidence and intensity with MTA Fillapex and AH Plus sealers were similar in asymptomatic vital molar teeth. Additionally, there was no statistically significant difference in the number of analgesic intake between the groups. With these findings, MTA based bioceramic sealers can be used as resin based sealers in daily endodontic practice with respect to postoperative pain in single-visit root canal treatment's of vital mandibular molar teeth with asymptomatic irreversible pulpitis.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry, Kök kanal tedavisi, Root canal therapy
