Amaç: Dentin hassasiyeti, popülasyonun büyük bir yüzdesini etkileyen önemli bir klinik problem olup; tedavisinde, açıkta kalan dentin tübüllerinin kapatılması için çeşitli materyaller ve yöntemler kullanılmaktadır. Dentin hassasiyeti için çeşitli tedavi yöntemleri önerilmiştir; ancak bugüne kadar tek bir materyal veya tedavi şeklinin üstün olduğu sonucuna varılamamıştır. Bu çalışmanın amacı, tarama elektron mikroskobu (TEM) kullanarak hassasiyet giderici ajan olan Gluma ve neodim katkılı itriyum alüminyum granat [neodymium doped yttrium aluminum garnet (Nd:YAG)] lazer uygulamasının insan dentin tübülleri üzerindeki in vitro etkilerini değerlendirmektir. Gereç ve Yöntemler: Çalışmamıza, yeni çekilmiş gömülü 3. azı dişlerinden elde edilen toplam 36 dentin örneği dâhil edilmiştir ve örnekler, 3 gruba ayrılmıştır: Grup 1 (Kontrol), Grup 2 (Gluma), Grup 3 (Nd:YAG). Örnekler; x500, x1.000 ve x2.000'lik büyütmelerde TEM ile incelenmiştir. Örnek başına toplam 10 görüntü alınmış; tamamen tıkalı, kısmen tıkalı ve tamamen açık dentin tübülleri sayılmıştır. Bulgular: İki test grubu da kontrol grubu ile karşılaştırıldığında istatistiksel olarak anlamlı derecede daha yüksek oranda tübül tıkanması olduğu tespit edildi (p=0,001). Toplam tübül sayısı tıkama oranında Nd:YAG grubunun, Gluma grubuna kıyasla daha başarılı olduğu görüldü (p=0,004). TEM görüntüleri incelendiğinde, Nd:YAG lazer uygulanan dentin yüzeylerinde farklı yapısal değişiklikler olduğu gözlendi. Sonuç: TEM analizi, tedavi gruplarının her ikisinde de dentin tübüllerinin tıkandığını göstermiştir. Ancak Nd:YAG lazer uygulanmış yüzeylerde, yüzey bütünlüğünün bozulmasına rağmen Gluma uygulanan grupta, yüzey bütünlülüğünde bozulma oluşmadığı tespit edilmiştir. Dentin hassasiyeti tedavisinde, her iki yöntem de başarılı ve uygulanabilir ancak Gluma uygulaması, dentin yüzeylerinde bozulmaya neden olmadığı için öncelikli olarak tercih edilebilir.
Anahtar Kelimeler: Dentin hassasiyeti; Gluma; lazer tedavisi
Objective: Dentin sensitivity is an important clinical problem that affects a large percentage of the population, and various materials and methods are used for occlusion of exposed dentinal tubules in its treatment. Various treatment modalities have been proposed for dentin sensitivity; however, no single material or treatment modality has been concluded to be superior to date. The aim of this study is to evaluate the in vitro effects of the desensitizing agent Gluma and neodymium doped yttrium aluminum garnet (Nd:YAG) laser application on human dentin tubules using scanning electron microscopy (SEM). Material and Methods: A total of 36 dentin samples obtained from newly extracted impacted 3rd molars were included in our study and the samples were divided into 3 groups; Group 1 (Control), Group 2 (Gluma), Group 3 (Nd:YAG). The samples were examined by SEM at x500, x1,000 and x2,000 magnifications. A total of 10 images were taken per sample and fully occluded, partially occluded, and fully open dentin tubules were counted. Results: A statistically significantly higher rate of tubule occlusion was found in both test groups compared to the control group (p=0.001). Nd:YAG group was found to be more successful in total tubule number occlusion ratio compared to Gluma group (p=0.004). When the SEM images were examined, it was observed that there were different structural changes on the Nd:YAG laser applied dentin surfaces. Conclusion: SEM analysis showed occlusion of dentinal tubules in both treatment groups. However, despite the deterioration of the surface integrity of the Nd:YAG laser applied surfaces, it was determined that there was no deterioration in the surface integrity of the Gluma applied group. Both methods are successful and applicable in the treatment of dentin sensitivity, but Gluma application can be preferred primarily because it does not cause deterioration on dentin surfaces.
Keywords: Dentin sensitivity; Gluma; laser therapy
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