Usporedba rotacijske i recipročne tehnike instrumentacije u uklanjanju bakterija iz korijenskog kanala zuba s kroničnim epikalnim parodontitisom

doctoral thesis

• Title (english): Comparison of rotary and reciprocating instrumentation technique in the eradication of bacteria from the root canal of teeth with chronical apical periodontitis
• Author: Anja Sesar
• Mentor: Ivona Bago (mentor)
• Mentor: Ana Budimir (komentor)
• Committee member: Ivica Anić (predsjednik povjerenstva)
• Committee member: Eva Klarić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Endodonics and Restorative Dentistry
• Universal decimal classification (UDC): 616.31 - Stomatology

Abstract

Svrha doktorskog rada bila je identificirati bakterijske vrste u nekrotičnim kanalima zuba s upalnim periapikalnim procesom, te ispitati antimikrobnu učinkovitost rotacijske i recipročne tehnike instrumentacije kanala u eliminaciji bakterijskih vrsta iz nekrotičnih kanala zuba s kroničnim apikalnim parodontitisom. U istraživanju je sudjelovalo četrdeset pacijenata s nalazom nekrotičnih zuba s kroničnim apikalnim parodintitisom, koji su izabrani temeljem definiranih kriterija uključivanja i isključivanja. Sudionici istraživanja su raspoređeni u jednu od dvije skupine ovisno o tehnici instrumentacije korijenskog kanala: Grupa 1. Wave One Gold; Grupa 2. ProTaper Next. U obje skupine, kanali su tijekom instrumentacije isprani s 2,5 % otopinom natrij hipoklorita (NaOCl), a završni protokol ispiranja uključivao je: 3 ml NaOCl, 2 ml etilendiaminotetraoctena kiselina (EDTA) i 2 ml NaOCl. Kod svih pacijenata provedeno je jednoposjetno endodontsko liječenje zuba s punjenjem kanala tehnikom hladne lateralne kondenzacije i punilom temeljenim na epoksi smoli. Jedan stomatolog je proveo sva endodontska liječenja. Mikrobiološki uzorci iz korijenskog kanala prikupljeni su tehnikom papirnatog štapića tri puta: prije instrumentacije (uzorak 1), nakon kemo-mehaničke obrade (uzorak 2) i nakon završnog ispiranja korijenskog kanala (uzorak 3). Provedena je mikrobiološka analiza, identifikacija bakterija MALDI-TOF masenom spektrometrijom i brojanje kolonija metodom kulture. Za statističku analizu korišten je Wilcoxon test i hi-kvadrat test uz razinu značajnosti od 0.05. Prvi uzorak pokazao je prisutnost 49 aerobnih i anaerobnih bakterijskih vrsta kod pacijenata. Nakon kemo-mehaničke obrade korijenskih kanala Wave One Gold i ProTaper Next tehnikom, broj bakterija je značajno smanjen u obje grupe (p<0,001). Završni protokol ispiranja također je dodatno smanjio broj bakterijskih vrsta u obje grupe (p<0,001). ProTaper Next tehnika i Wave One Gold tehnika pokazale su sličnu učinkovitost u
smanjenju broj bakterijakih kolonija (p>0,05). Obje tehnike instrumentacije bile su jednako učinkovite u uklanjanju bakterija iz korijenskih kanala.

Abstract (english)

Aim: Identify bacterial species in necrotic root canals of teeth with chronic apical periodontitis, and to evaluate the antimicrobial effectiveness of rotary and reciprocating instrumentation techniques in the elimination of bacterial species from necrotic canals of teeth with chronic apical periodontitis.
Materials and methods: Forty patients with necrotic teeth with chronic apical periodontitis were selected for this study based on previously defined inclusion and exclusion criteria. After they had signed an informed consent, the participants were included in this clinical study and randomly assigned to one of two experimental groups depending on the root canal
instrumentation technique used: Group 1. Wave One Gold technique; Group 2. ProTaper Next instrumentation technique. In both groups, root canals were irrigated with 2.5% sodium hypochlorite (NaOCl) solution during the instrumentation, and then the final irrigation protocol was applied in both groups: 3 ml NaOCl, 2 ml ethylenediaminetetraacetic acid (EDTA) and 2
ml NaOCl. A single visit root canal treatment was performed by one doctor of dental medicine, who finished intracanal procedures by the cold lateral condensation technique using an epoxy resin based sealer and gutta-percha. Microbiological samples from the root canal were collected for three times using a paper point technique: before instrumentation (sample 1.), after chemomechanical treatment (sample 2.) and after the final irrigation protocol (sample 3.). Microbiological analysis was carried out by identification of bacteria using MALDI-TOF mass spectrometry and colony forming units (CFUs) counting by the culture method. The Wilcoxon and chi-quadrat test were used for statistical analysis with a significance level of 0.05.
Results: The first sample showed the presence of aerobic and anaerobic bacterial species in the patients. After chemo-mechanical treatment of root canals with Wave One Gold and ProTaper Next technique, the number of bacteria was significantly reduced in both groups (p<0.001). The final irrigation protocol also further reduced the number of bacterial species in both groups (p<0.001). The ProTaper Next technique and Wave One Gold technique were similarly successful in reducing the number of bacterial colonies (p>0,05).

• Keywords: endodoncija; periapikalni parodontitis; bakterije; materijali za punjenje korijenskog kanala
• Keywords (english): Endodontics; Periapical Periodontitis; Bacteria; Root Canal Filling Materials
• Language: croatian
• URN:NBN: urn:nbn:hr:127:197257
• Promotion: 2024
• Study programme: Title: Dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti u području biomedicine i zdravstva (doktor/doktorica znanosti u području biomedicine i zdravstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-10-23 10:17:50