Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Taşkın Kök Kanal Dolgu Patları ve Bunların Çeşitli Risk Faktörleriyle İlişkilerinin İncelenmesi: Retrospektif Bir Araştırma
The Evaluation of Apically Extruded Sealers and Their Relationship to Various Risk Factors: A Retrospective Research
Büşra KOÇAKa, Emel Olga ÖNAYa, Cemre KOÇa, Mete ÜNGÖRb
aBaşkent Üniversitesi Diş Hekimliği Fakültesi, Endodonti ABD, Ankara, Türkiye
bMedipol Üniversitesi Diş Hekimliği Fakültesi, Endodonti ABD, İstanbul, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(2):381-9
doi: 10.5336/dentalsci.2021-85006
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, kök kanal tedavisi uygulanmış daimî dişlerde, apikalden istemsiz olarak taşan kök kanal dolgu patlarını değerlendirmek ve bu durumu etkileyen olası risk faktörlerini belirlemektir. Gereç ve Yöntemler: Çalışmada, tek bir operatör tarafından 18 yıl 6 ay boynunca tedavi edilen 5.381 adet hastaya ait dişler incelenmiş ve çalışmaya toplam 7.761 diş dâhil edilmiştir. Hastanın yaşı, cinsiyeti, pulpal ve periapikal hastalığın teşhisi, ilgili dişin tipi, tedavinin şekli [birincil tedavi (vital, devital), tekrarlayan tedavi], kanal dolum tekniği, hangi kök kanal patının kullanıldığı ve tedavi seans sayısı gibi faktörler incelenerek, taşkın pat gelişimi üzerinde en fazla belirleyici olan etkenin tespit edilmesi sağlandı. İstatistiksel analiz, tek değişkenli ve çoklu değişkenli lojistik regresyon analizleri kullanılarak yapıldı. Bulgular: Olguların ortalama yaşı 43,7±16,6 (yıl) olup; 2.251'i (%41,8) erkeklerden, 3.130'u (%58,2) kadınlardan oluşmaktaydı. Taşkın pat, 7.761 adet dişin 535 (%6,9) tanesinde gözlendi. Birincil tedavi gören vital dişlere göre birincil tedavi gören devital dişlerde (p<0,001) ve tekrarlayan tedavi gören dişlerde (p=0,002), taşkın pat görülme ihtimali daha fazla idi. Kanal dolum tekniği açısından basit tek kon veya vertikal kondensasyon (VK) uygulanan dişlere göre sadece lateral kondensasyonla (LK) (p=0,004) ve LK+VK (p=0,002) ile dolum yapılan dişlerde patın taşma olasılığının daha fazla olduğu belirlendi. AH Plus'a göre AH 26 kullanımının, taşkın pat görülme ihtimalini artırdığı tespit edildi (p=0,002). Sonuç: Nekrotik ve/veya periapikal lezyonlu dişlerde gerçekleştirilen birincil ve tekrarlayan tedavilerin, kanal dolum tekniklerinden LK'nin, LK ile birlikte VK'nin kombine bir şekilde kullanılmasının, kanal dolgu patı olarak AH 26'nın seçilmesinin, pat taşkınlığı anlamında risk faktörleri olduğu belirlenmiştir.

Anahtar Kelimeler: Kök kanalını tıkama; kök kanal tıkaçları; kök kanal tedavisi
ABSTRACT
 Objective: The aim of this study is to evaluate the unintentionally apically extruded root canal sealers in endodontically treated teeth and to determine the possible risk factors affecting this situation. Material and Methods: Records of 7,761 teeth belonging to 5,381 patients treated by a single operator during18 years and 6 months were included. The most determining factor on extruded sealer was identified considering the patient's age, gender, diagnosis of pulpal and periapical disease, tooth type, treatment modality [primary treatment (vital, mortal), retreatment], filling technique, sealer choice, and the number of visits. Statistical analysis was carried out by using univariate binary and multivariate logistic regression analyses. Results: The mean age was 43.7±16.6 (years) and 2,251 (41.8%) were men and 3,130 (58.2%) were women. Extruded sealer was observed in 535 (6.9%) of 7,761 teeth. The incidence of sealer extrusion was higher in primarily treated mortal teeth (p<0.001) and retreated teeth (p=0.002) compared to primarily treated vital teeth. In terms of root canal filling technique, it was determined that the probability of sealer extrusion was higher in teeth filled with only lateral condensation (LC) (P=0.004) and LC+vertical condensation (VC) (p=0.002) compared to teeth filled with simple single cone or VC techniques. The use of AH 26 increased the incidence of sealer extrusion compared to AH Plus (p=0.002). Conclusion: It has been determined that primary treatments and retreatments performed in teeth with necrotic and/or periapical lesions, the use of LC, LC in combination with VC, and the choice of AH 26 as a sealer are risk factors in terms of sealer extrusion.

Keywords: Root canal obturation; root canal filling materials; root canal therapy
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