Kök kanal patı kaynaklı koronal renk değişikliğinin önlenmesinde farklı yöntemlerin etkinliğinin değerlendirilmesi

BEYZA TALU KARABEKİR

Kök kanal patı kaynaklı koronal renk değişikliğinin önlenmesinde farklı yöntemlerin etkinliğinin değerlendirilmesi

Thesis Type: Dental Specialty

Institution Of The Thesis: Sivas Cumhuriyet University, Diş Hekimliği Fakültesi, Klinik Bilimler Bölümü, Turkey

Approval Date: 2024

Thesis Language: Turkish

Student: BEYZA TALU KARABEKİR

Supervisor: Demet Altunbaş

Open Archive Collection: AVESIS Open Access Collection

Abstract:

In this study, the effects of dentin bonding agent, Teethmate Desensitizer, and KTP laser, which block dentinal tubules with different mechanisms, in preventing discoloration induced by two different root canal sealer were investigated. In addition, coronal color changes caused by AH Plus and MTA Fillapex root canal sealer were comparatively examined. 180 extracted mandibular incisors with single roots and oval-shaped single canals were used in the study. The segments of the roots were removed approximately 2 mm below the cemento-enamel junction of the teeth and composite frames were created on the vestibule surfaces of the crowns where the tip of the spectrophotometer would be placed. The pulp chamber was instrumented through the opening created at the apex and irrigation was performed with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. 20 of the prepared teeth were selected as the negative control group and no procedure was applied to the teeth. The remaining 160 teeth were randomly divided into 8 groups as AH Plus-Bond, AH Plus-Desensitizer, AH Plus-KTP laser, AH Plus positive control, MTA Fillapex-Bond, MTA Fillapex-Desensitizer, MTA Fillapex-KTP laser and MTA Fillapex positive control (n=20). Relevant dentinal tubule occlusion methods were applied to the Bond, Desensitizer and KTP laser groups. Root canal sealer was placed in the positive control groups without any tubule occlusion method. Then, the teeth with closed apical openings were stored in an incubator at 37°C and 100% humidity. Color measurements of the teeth were made using a spectrophotometer before the procedure, immediately after the procedure, at 1 month, 3 months, and 6 months. ΔE values of each sample at different time intervals were calculated using the L*, a*, b* (CIELab*) values determined in the measurements. The clinical perceptibility threshold of color change was accepted as 3.3 units. The obtained data were statistically analyzed with Kolmogorov-Smirnov, Shapiro-Wilk, t test, variance analysis, Bonferroni and Tamhane's T2 multiple comparison tests, and the significance level was accepted as p<0.05. The AH Plus positive control group showed maximum color change at 3rd month. This change decreased at 6th month. In the MTA Fillapex positive control group, an increase in color change was observed in proportion to time. Except for 6th month, the AH Plus positive control group showed more color change than the MTA Fillapex positive control group at other time intervals. In the color measurements taken at 6th month, more color change was observed in the AH Plus-KTP laser group than in the AH Plus-Bond and AH Plus-Desensitizer groups, but there was no difference between the prevention methods at 3rd month. No difference was observed between the groups where MTA Fillapex was placed and the prevention method was applied at 1st, 3rd, and 6th month. According to the findings obtained from the study, it was determined that all three tubule occlusion methods used prevented the maximum color change observed at 3rd month due to AH Plus paste. The fact that the teeth with DBA and desensitizer applied showed discoloration below the clinically detectable level at 6 months in both root canal paste groups and the discoloration was not statistically different from the negative control group, indicating that these two procedures were effective in preventing root canal paste-induced coronal discoloration.