<p>Uvod: Sistem kanala korena je složena celina koja pored glavnog korenskog kanala sadrži brojne lateralne, sekundarne, akcesorne kanale, apikalne istmuse i delte, kao i razgranatu mrežu dentinskih tubula. Kako korensko kanalni sistem ne može biti u potpunosti očišćen i dezinfikovan postojećim tehnikama instrumentacije, irigacije i intrakanalne medikacije, uloga kanalnog punjenja se ogleda u postizanju trodimenzionalne opturacije kanalnog prostora, ”pečaćenju” preostalih bakterija i onemogućavanju njihovog prodora u periradikularna tkiva. Ispitivanjem reoloških svojstava mogu se bliže odrediti karakteristike tečenja i viskoelastična svojstva endodontskih materijala. Definisanje i razumevanje reoloških svojstava endodontskih silera u različitim uslovima doprinosi pravilnom rukovanju materijalom shodno primenjenoj tehnici opturacije. Cilj istraživanja: ispitivanje viskoelastičnih svojstava tri različita endodontska silera, uključujući i tečenje / prodor silera u dentinske tubule u kombinaciji sa različitim tehnikama opturacije. Materijal i metode: Ukupan uzorak činilo je 132 meziobukalna i meziolingvalna kanala korena prvih donjih molara. Nakon preparacije kanala krunično-apeksnom tehnikom i ProTaper endodontskim instrumentima, uzorak je podeljen u tri grupe u zavisnosti od ispitivanog silera (AH Plus, Sealapex i EndoREZ) i dodatno u četiri podgrupe shodno primenjenoj tehnici opturacije (hladna lateralna kompakcija, monokona tehnika, opturacija sa čvrstim nosačem gutaperke i topla vertikalna kompakcija), što je činilo ukupno 12 grupa po 11 kanala. Nakon opturacije, uzorci su poprečno presečeni na rastojanju 3, 5 i 8mm od anatomskog foramena, kako bi se dobili preseci koji odgovaraju apikalnoj, srednjoj i koronarnoj trećini kanala. Koronarne površine preseka su analizirane skening elektronskim mikroskopom (SEM). Mesto najdubljeg tubularnog prodora silera je izmereno i izraženo u mikrometrima i procentualno u odnosu na ukupno rastojanje dentinski zid kanala - spoljašnja površina korena. Viskoelastična svojstva endodontskih silera su ispitana na dinamičkom oscilatornom reometru, frequency sweep testom, na četiri različite temperature: 25°C, 35°C, 40°C i 65°C. Rezultati: Tehnike opturacije silerom AH Plus koje primenjuju toplotu i pritisak daju značajno višu dubinu prodora silera u dentinske tubule u odnosu na tehnike koje ne primenjuju. Primena toplote i pritiska tokom opturacije silerom Sealapex nema značajnu ulogu u dubini prodora silera u dentinske tubule. Tehnike opturacije silerom EndoREZ koje ne primenjuju toplotu i pritisak daju značajno višu dubinu prodora silera u dentinske tubule u odnosu na tehnike koje primenjuju. Dubina prodora sva tri ispitivana endodontska silera u dentinske tubule je najviša u koronarnoj trećini, zatim srednjoj i značajno je niža u apikalnoj trećini kanala korena. AH Plus, Sealapex i EndoREZ ispoljavaju viskoelastični karakter sa dominantnim vrednostima elastičnog modula u odnosu na vrednosti viskoznog modula, na svim zadatim temperaturama, u opsegu primenjenih frekvencija i napona smicanja. Kompleksni viskozitet svih ispitivanih silera opada sa porastom frekvencije, na svim zadatim temperaturama. Sa porastom temperature kompleksni viskozitet silera AH Plus opada, dok za silere Sealapex i EndoREZ raste. Korelacionom analizom ustanovljena je jaka negativna korelacija između kompleksnog viskoziteta ispitivanih silera i dubine prodora u dentinske tubule: opadanjem kompleksnog viskoziteta dubina prodora silera u dentinske tubule raste. Zaključak: Odabir endodontskog silera treba da je zasnovan na tehnici opturacije koja se primenjuje.</p> / <p>Introduction: The root canal system has a complex anatomy with main root canal and many lateral, secondary, accessory canals, apical isthmuses and deltas, as well as numerous branched dentinal tubules. Due to its complexity, the root canal system cannot be completely cleaned, shaped and disinfected using available techniques of instrumentation, irrigation and intracanal medication. The aim of root canal filling is to achieve a three-dimensional obturation of the root canal space, entomb residual bacteria and prevent their penetration into the periradicular tissue. Defining and understanding the rheological properties of endodontic sealers in different conditions contributes to the proper handling of the material according to the obturation technique applied. The aim: testing the viscoelastic properties of three different endodontic sealers, including the flow / sealer penetration into dentinal tubules in combination with different obturation techniques. Materials and Methods: The total sample consisted of 132 mesiobuccal and mesiolingual root canals of first mandibular molars. After root canal preparation using ProTaper endodontic instruments, in crown-down manner, the sample is divided into three groups depending on the tested sealers (AH Plus, Sealapex and EndoREZ) and additionally into four subgroups according to the obturation technique applied (cold lateral compaction, single-cone technique, carrier – based obturation and warm vertical compaction), making a total of 12 groups of 11 canals. After root canal obturation, the samples were sectioned horizontally at 3, 5 and 8mm from the anatomical foramen, in order to get the sections that correspond to the apical, middle and coronary third of the canal. The coronal surfaces of the sections were analyzed using scanning electron microscopy (SEM). The maximum depth of sealer penetration was measured and expressed in micrometers and as a percent of the total distance: canal dentinal wall - the outer surface of the root. The viscoelastic properties of endodontic sealers were measured using frequency sweep test on dynamic oscillatory rheometer, at four different temperatures: 25°C, 35°C, 40°C and 65°C. Results: Obturation techniques with AH Plus that applied heat and pressure produced a significantly higher depth of sealer penetration into dentinal tubules as compared to techniques that did not apply. The application of heat and pressure during obturation with Sealapex had no a significant role in the depth of sealer penetration into dentinal tubules. Obturation techniques with EndoREZ that did not apply heat and pressure produced a significantly higher depth of sealer penetration into dentinal tubules as compared to techniques that applied. The depth of penetration of all three endodontic sealers into dentinal tubules was the highest in the coronary third, followed by the second and was significantly lower in the apical third of the root canal. AH Plus, Sealapex and EndoREZ exhibited viscoelastic character with dominant values of elastic over viscous modulus, at all specified temperatures, in the range of applied frequencies and shear stresses. Complex viscosity of all sealers decreased as the frequency increased at all temperatures. AH Plus showed decreased viscosity as the temperature increased, while Sealapex and EndoREZ demonstrated opposite behavior. Correlation analysis has established a strong negative correlation between the complex viscosity of the tested sealers and the depth of penetration into dentinal tubules: the decrease of complex viscosity increase the depth of sealer penetration into dentinal tubules. Conclusion: The choice of endodontic sealer should be based on the obturation technique applied.</p>
| Identifer | oai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)101723 |
| Date | 09 December 2016 |
| Creators | Premović Milica |
| Contributors | Zorica Dušan, Petrović Ljubomir, Stojanac Igor, Beljić-Ivanović Katarina, Drobac Milan, Krstonošić Veljko, Atanacković Teodor |
| Publisher | Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad |
| Source Sets | University of Novi Sad |
| Language | Serbian |
| Detected Language | Unknown |
| Type | PhD thesis |
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