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Experimental and clinical evaluationOf adhesion of different materials forThe root canal obturation

dc.contributor.advisorJakovljević, Ankica
dc.contributor.otherJakovljević, Ankica
dc.contributor.otherPap, Katarina
dc.contributor.otherPopović, Milica
dc.creatorМелих, Ирена
dc.date.issued2015-05-13
dc.identifier.urihttp://www.cris.uns.ac.rs/DownloadFileServlet/Disertacija143254768582833.pdf?controlNumber=(BISIS)94930&fileName=143254768582833.pdf&id=3748&source=NaRDuS&language=srsr
dc.identifier.urihttp://www.cris.uns.ac.rs/record.jsf?recordId=94930&source=NaRDuS&language=srsr
dc.identifier.urihttp://www.cris.uns.ac.rs/DownloadFileServlet/IzvestajKomisije143556261711590.pdf?controlNumber=(BISIS)94930&fileName=143556261711590.pdf&id=3883&source=NaRDuS&language=srsr
dc.identifier.urihttp://nardus.mpn.gov.rs/123456789/4158
dc.description.abstractNajpoželjnija osobina materijala za opturaciju je adhezivnost, još od vremena kada je dokazano da gutaperka nema sposobnost vezivanja za zidove kanala korena. Povećanjem adhezije za dentinske zidove, značajno se smanjuje apikalno i koronarno mikrocurenje, i poboljšava se zaptivanje. Napredak adhezivnih tehnologija u stomatologiji je doveo do implementiranja adhezivnih sistema u endodonciju. Tako su se uvodili novi sistemi sa ciljem da se stvori monoblok, pri čemu bi konus, siler i dentin kanala korena ostvarili jednu kohezivnu jedinicu. Istraživanja su pokazala da se primenom ovih sistema značajno redukuje apikalno mikrocurenje kao i da se povećava otpornost lečenog zuba na pritisak Cilj istraživanja bio je da se u in vitro i u in vivo uslovima ispitaju adhezivna svojstva savremenih i konvencionalnih materijala za opturaciju i da se utvrdi u kojoj meri ona utiču na zaptivanje kanala korena zuba. U metodologiji istraživanja za proučavanje adhezivnosti tri različita materijala korišćena su dva eksperimentalna modela: Push-out test i skening elektronska mikroskopija. In vivo studija je izvedena po modelu prospektivne kliničke studije. Testirana su tri materijala, dva konvencionalna i jedan novi: AH Plus siler, Acroseal siler i Resilon sistem. Pored adhezivnosti samih testiranih materijala, ispitivan je i uticaj metode uklanjanja razmaznog sloja i tehnike opturacije na adhezivnost materijala. Za eksperimentalni deo istraživanja korišćeno je 300 ekstrahovanih mandibularnih premolara. Nakon endodontske obrade zubi su podeljeni u dve grupe na osnovu metode kojom je uklanjan razmazni sloj. U prvoj grupi razmazni sloj je uklanjan pomoću rastvora EDTA, dok je u drugoj uklanjan pomoću Er:YAG lasera. Nakon toga zubi svake grupe su podeljeni u tri podgrupe u odnosu na ispitivani materijal. U svakoj podgrupi uzorci su opturirani pomoću dve tehnike opturacije: monokone ili hladne lateralne kondenzacije. Iz svake podgrupe po 15 uzoraka je odvojeno za Push-out test, a preostalih 10 je posmatrano pod skening elektronskom mikroskopijom. U okviru kliničke studije tokom dvogodišnjeg perioda praćena je uspešnost terapije postignuta sa tri različita materijala kod endodontski lečenih zuba sa dijagnozom pulpopatije. Rezultati Push-out testa su pokazali da je da je utvrĎena statistički značajna razlika (P<0,05) u prosečnim vrednostima adhezivnosti ispitivanih materijala. Nije bilo statistički značajne razlike izmeĎu AH Plus silera sa gutaperkom i Resilon sistema. Acroseal siler je pokazao statistički značajno (P<0,05) lošiju adheziju u odnosu na druga dva ispitivana materijala. Možemo da kažemo da je statistički značajno bolja (P<0,05) adhezija materijala za dentin ostvarena kod grupe kod koje je razmazni sloj uklanjan rastvorom EDTA u odnosu na grupu u kojoj je uklanjan laserom. Na osnovu rezultata možemo reći da je statistički značajno bolja (P<0,05) adhezija ostvarena kod uzoraka koji su opturirani tehnikom hladne lateralne kondenzacije. Rezultati skening elektronske mikroskopije su pokazali da je bilo statistički značajne razlike (P<0,05) u adaptaciji za dentinski zid izmeĎu uzoraka koji su opturirani sa tri različita materijala. Nije bilo statistički značajne razlike (P>0,017) u adaptaciji izmeĎu uzoraka koji su opturirani AH Plus silerom sa gutaperkom i Resilon sistemom. Statistički značajno (P<0,017) lošija adaptacija je ostvarena primenom Acroseal silera i gutaperke u odnosu na druga dva ispitivana materijala. Tehnika uklanjanja razmaznog sloja nije uticala na adaptaciju uzoraka opturiranih odreĎenim materijalima. Možemo reći da je bolja adaptacija materijala za dentinske zidove uočena kod uzoraka koji su opturirani tehnikom hladne lateralne kondenzacije. Rezultati kliničke studije su pokazali da je uspešan terapijski ishod uočen u 97% slučajeva, kao i da nije bilo statistički značajne razlike u ishodu terapije koje su postignute različitim materijalima za opturaciju. Zaključuje se da je Resilon, kao novi adhezivni materijal na bazi metakrilata pokazao dobru adhezivnost i da se može koristiti podjednako uspešno kao AH Plus siler i gutaperka. Na žalost, nije pokazao superiornost da bi potisnuo gutaperku iz savremene endodontske prakse i zamenio je. Tehnika opturacije utiče na adhezivnost materijala za opturaciju i prednost treba dati tehnici hladne lateralne kondenzacije. Tehnika uklanjanja razmaznog sloja takoĎe utiče na adhezivnost materijala za opturaciju.sr
dc.description.abstractThe most preferred properties of sealer is adhesiveness, since it was proved that the gutta-percha had no ability to bind to the root canal walls. Increasing of the adhesion to dentin walls significantly reduced apical and coronal microleakage, and ensure an adequate seal. The progress of adhesive technology in dentistry has led to the implementation of adhesive systems in Endodontics. A new systems were introduced in order to create a monoblock, where the cone, sealer and dentin of the root canal achieve a cohesive unit. Studies have shown that use of this system significantly reduces apical microleakage and increase the resistance to fracture of the treated tooth. The aim of the study was to establish in vitro and in vivo examination of the adhesive properties of conventional and advanced materials for root canal obturation and to determine how they affect the sealing of the root canal. For evaluating the adhesiveness of three different materials, two experimental models were used: Push-out bond test and scanning electron microscopy. In vivo studies have been performed on the model of prospective clinical trials. Three materials were tested, two conventional and one new: AH Plus sealer, Acroseal sealer and Resilon system. In addition, the influence of smear layer removal techniques and obturation techniques on adhesion of different materials were examined. In the investigation 300 extracted mandibular premolars were used. After endodontic treatment the teeth were divided into two groups based on the technique of removing the smear layer. In the first group, the smear layer was removed by the EDTA solution, and in the second group with a Er:YAG laser. After that, the teeth of each group were divided into three subgroups with in regards to the test material. In each subgroup samples were obturated using two techniques: monocone or cold lateral condensation. From each subgroup, 15 samples were singled out for Push-out bond test, and the remaining 10 were observed under scanning electron microscopy. Within the clinical studies in teeth obturated with investigated materials, success of therapy was followed over a two year period. Results of the Push-out bond test showed statistically significant difference (P<0.05) in adhesion of investigated materials. There were no statistically significant differences between AH Plus sealer and Resilon system. Acroseal sealer showed a statistically significant (P<0.05) poorer adhesion compared to the other two tested materials. It can be said that significantly better adhesion to dentin was achieved in the group in which the smear layer was removed by EDTA solution compared to the laser group. Based on the results it can be said that significantly better adhesion was achieved when cold lateral condensation technique was applied. The results of scanning electron microscopy showed that there were statistically significant differences (P<0.05) in the adaptation of three different materials to the dentinal wall. There was no statistically significant difference (P> 0.017) in the adaptation between AH Plus sealer group and Resilon group. Statistically significant poorer adaptation was achieved using Acroseal sealer and gutta-percha in comparison to the two other tested materials (P<0.017). The smear layer removing technique did not affect on the adaptation of tested materials. It can be said that better adaptation of materials to the dentin walls was found in samples opturated by cold lateral condensation technique. Results of clinical studies have demonstrated that a successful therapeutic outcome was observed in 97% of cases. There was no statistically significant difference (P>0,05) in the outcome of therapy that are achieved with different materials. It can be concluded that the Resilon, as the new adhesive material based on methacrylates showed good adhesion and can be used equally well as AH Plus sealer and gutta-percha. Unfortunately, it was not superior enough to suppress the gutta-percha from contemporary endodontic practice and replace it. Obturation techniques affect the adhesion of sealer and priority should be given to the technique of cold lateral condensation. The technique of removing the smear layer affect the adhesion of sealer too.en
dc.languagesr (latin script)
dc.publisherУниверзитет Привредна академија у Новом Саду, Стоматолошки факултет, Панчевоsr
dc.rightsAttribution-NonCommercial-NoDerivs
dc.sourceУниверзитет Привредна академија у Новом Садуsr
dc.subjectadhezija, zaptivanje, sileri, Resilon, Push-out test, SEM, klinička studijasr
dc.subjectadhesion, sealing, obturation materials, Resilon, Push-out bond test, Er:YAG laser, SEM, clinical studyen
dc.titleEksperimentalno i kliničko ispitivanje adhezije različitih materijala za punjenje kanala korenasr
dc.titleExperimental and clinical evaluationOf adhesion of different materials forThe root canal obturationen
dc.typeThesissr


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