İki farklı kavite preparasyonu ve iki farklı adeziv ajan kullanılarak yapılan inley tutuculu posterior adeziv köprülerin çekme kuvvetine dirençlerinin in-vitro incelenmesi
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2015
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info:eu-repo/semantics/closedAccess
Özet
Rezin-bağlı sabit bölümlü protezler uzun zamandan beri, geleneksel sabit bölümlü protezlerin yerine kullanılabilmektedir. Daha az invaziv olan bu restorasyonlar, dişhekimliği hizmetine ilk sunulduklarından bu yana birçok gelişme kaydetmiştir. Bu gelişmelere bağlı olarak da başarı oranları zaman içerisinde artış göstermiştir. Geleneksel yaklaşımlar, yerini, uygulaması daha çabuk ve basit olan yeni tekniklere bırakmış ve böylece, yeni ile eski arasındaki farkın araştırılması gerekliliği doğmuştur. Bu çalışmanın amacı, yeni kullanılmaya başlanmış bir rezin-bağlı sabit bölümlü protez yapım tekniği ile geleneksel yapım tekniği kullanılarak yapılan inley tutuculu posterior adeziv köprüleri, diş sert dokularına tutuculukları bakımından in-vitro olarak karşılaştırmak ve bu restorasyonların simantasyonunda kullanılabilecek iki farklı antibakteriyel etkili adeziv sistem uygulamasının tutuculuğa etkisini sınamaktı. Çekilmiş molar dişler kullanılarak tek diş (molar) eksikliği modeli oluşturulmuş örnekler, 4 gruba (Mod-G1, Mod-G2, Gel-G1, Gel-G2) ayrıldı (n=10). Mod-G1 ve Mod-G2 grupları, yeni kullanılmaya başlanmış modifiye inley destekli slot tipi rezin-bağlı sabit bölümlü protezleri, Gel-G1 ve Gel-G2 grupları ise geleneksel inley destekli slot tipi rezin-bağlı sabit bölümlü protezleri temsil etmekteydi. Ayrıca, Mod-G1 ve Gel-G1 grupları, simantasyon esnasında, klorheksidin-bazlı bir kavite dezenfektanıyla kombine kullanılmış 10-methacryloyloxydecyl dihydrogen phosphate içerikli sıradan bir adeziv sistemi temsil ederken, Mod-G2 ve Gel-G2 grupları, antibakteriyel özellikli, 12-methacryloyloxydodecylpyridinium bromide içerikli yeni geliştirilmiş bir adeziv sistemi temsil etmekteydi. Her bir gruba, soy olmayan metal kullanılarak köprüler hazırlandı, ve bunların tutucu kısımları, simantasyondan önce, alüminyum oksit partikülleriyle kumlama işlemine tabii tutuldu. Tüm örneklerin simantasyonunda 10-methacryloyloxydecyl dihydrogen phosphate içerikli dual-cure adeziv siman kullanıldı. Simante edilen köprüler bir hafta suda bekletildikten sonra, destek dişlerden ayrılana kadar sabit hızlı çekme kuvvetine maruz bırakıldılar. Gruplar, çekme testi sonuçları bakımından istatistiksel olarak karşılaştırıldı. Örneklerin ayrılma karakterleri ve ayrılırken destek dişlere verdikleri zarar da not edildi. Gruplar için hesaplanan ortalama çekme kuvvetine direnç değerleri; Mod-G1 için 355,71 N, Mod-G2 için 305,27 N, Gel-G1 için 466,76 N, ve Gel- G2 için 454,87 N idi. Gel-G1 ve Gel-G2 grupları için hesaplanan ortalama direnç değeri, Mod-G1 ve Mod-G2 için hesaplanandan istatistiksel olarak farklı bulundu. Örneklerin ayrılma karakteri, mensup oldukları gruptan bağımsız olarak, çoğunlukla, metal-siman sınırında adeziv olarak gerçekleşti. Ayrılma esnasında, hemen her örnekte diş harabiyeti gözlendi. Tutuculuğa etkileri karşılaştırılmaya çalışılan iki farklı kavite dezenfeksiyonu yaklaşımı arasında istatistiksel fark bulunamadı, fakat, elde edilen sonuçlar, örneklerin ayrılma karakterleri yüzünden yorumlanmaya müsait değildi. Geleneksel dizayna sahip rezin-bağlı sabit bölümlü protezler, modifiye dizayna sahip olanlara göre daha tutucu bulunmuştur. Fakat, sundukları uygulama kolaylıkları ve diş sert dokularına tutunmada gösterdikleri performanstan dolayı, modifiye inley destekli slot tipi rezin-bağlı sabit bölümlü protezlerin klinik açıdan daha yüksek tercih edilme potansiyeline sahip oldukları kanısına varılmıştır. Bu tip restorasyonların simantasyonunda, ek dezenfektan uygulaması gerektirmeyen antibakteriyel özellikli adeziv ajan kullanmanın daha avantajlı olduğuna karar verilmiştir. Anahtar Kelimeler: Rezin-bağlı sabit bölümlü protezler; İnleyler; Kavite dezenfektanları; Antibakteriyel adeziv sistemler.
Resin-bonded fixed partial dentures have been an alternative for the conventional full coverage fixed partial dentures for a long time. Since, first been introduced, this minimally invasive approach had undergone a lot of changes that have improved its success rate over time. Conservative modalities have been replaced by newer, more practical ones, and this has induced the need for comparing the benefits of the new and the old methods. The purpose of this study was to test and compare in-vitro the resistance of a newly introduced modified inlay retained posterior resinbonded fixed partial dentures, and conventional inlay retained posterior resinbonded fixed partial dentures to detachment from dental hard tissue. The effect of varying the dentin adhesive system combination exhibiting antibacterial properties was also investigated. Extracted molars were used to prepare specimens of pare of teeth with a space equivalent to a molar in between. Four test groups (Mod-G1, Mod-G2, Gel-G1, Gel-G2) were prepared (n=10). Groups Mod-G1 and Mod- G2 were representing the newly introduced modified inlay retained posterior resin-bonded fixed partial denture specimens incorporating slot cavity design, whereas, Gel-G1 and Gel-G2 were representing the conventional specimens also incorporating slot cavity design. Mod-G1 and Gel-G1 were also standing for the specimens that combined a 10-methacryloyloxydecyl dihydrogen phosphate containing dentin adhesive system with a chlorhexidine-based cavity disinfectant, and groups Mod-G2 and Gel-G2 were standing for a 12- methacryloyloxydodecylpyridinium bromide containing dentin adhesive system with an antibacterial cavity cleansing effect. Castings for each group were made and their fit surfaces sandblasted with aluminum oxide powder. All castings were cemented with 10-methacryloyloxydecyl dihydrogen phosphate containing dual-cure adhesive resin cement. After being immersed for at least one week in water, specimens were subjected to permanent tensile loading until separation occurred. Specimens were examined to determine the mode of separation, and occurred tooth fracture in terms of damage seriousness was noted. Results were then statistically evaluated. Mean separation forces were: group Mod-G1=355.71 N, group Mod- G2=305.27 N, group Gel-G1=466.76 N, and group Gel-G2=454.87 N. Groups Gel-G1 and Gel-G2 had significantly higher mean separation forces than groups Mod-G1 and Mod-G2. The mode of separation, independent from any group, was associated with a high frequency of adhesive failure at the metal-resin cement interface and tooth fracture was observed nearly in all specimens. No significant difference was detected between the two antibacterial adhesive system applications tested. But, due to the mode of specimen separation, this result was out of keeping with commentary. Conventional inlay retained posterior resin-bonded fixed partial dentures were found to be more retentive than modified inlay retained posterior resin-bonded fixed partial dentures. However, the simpler application procedure and the retentive performance demonstrated by the modified inlay retained posterior resin-bonded fixed partial dentures incorporating slot cavity design, had been persuading about their higher clinically admittance potential. It has been concluded that using a dentin adhesive system incorporating an antibacterial element, rather than adhesive system combined with a separate antibacterial agent application would be more favorable. Key Words: Resin-bonded fixed partial dentures; Inlays; Cavity disinfectants; Antibacterial adhesive systems.
Resin-bonded fixed partial dentures have been an alternative for the conventional full coverage fixed partial dentures for a long time. Since, first been introduced, this minimally invasive approach had undergone a lot of changes that have improved its success rate over time. Conservative modalities have been replaced by newer, more practical ones, and this has induced the need for comparing the benefits of the new and the old methods. The purpose of this study was to test and compare in-vitro the resistance of a newly introduced modified inlay retained posterior resinbonded fixed partial dentures, and conventional inlay retained posterior resinbonded fixed partial dentures to detachment from dental hard tissue. The effect of varying the dentin adhesive system combination exhibiting antibacterial properties was also investigated. Extracted molars were used to prepare specimens of pare of teeth with a space equivalent to a molar in between. Four test groups (Mod-G1, Mod-G2, Gel-G1, Gel-G2) were prepared (n=10). Groups Mod-G1 and Mod- G2 were representing the newly introduced modified inlay retained posterior resin-bonded fixed partial denture specimens incorporating slot cavity design, whereas, Gel-G1 and Gel-G2 were representing the conventional specimens also incorporating slot cavity design. Mod-G1 and Gel-G1 were also standing for the specimens that combined a 10-methacryloyloxydecyl dihydrogen phosphate containing dentin adhesive system with a chlorhexidine-based cavity disinfectant, and groups Mod-G2 and Gel-G2 were standing for a 12- methacryloyloxydodecylpyridinium bromide containing dentin adhesive system with an antibacterial cavity cleansing effect. Castings for each group were made and their fit surfaces sandblasted with aluminum oxide powder. All castings were cemented with 10-methacryloyloxydecyl dihydrogen phosphate containing dual-cure adhesive resin cement. After being immersed for at least one week in water, specimens were subjected to permanent tensile loading until separation occurred. Specimens were examined to determine the mode of separation, and occurred tooth fracture in terms of damage seriousness was noted. Results were then statistically evaluated. Mean separation forces were: group Mod-G1=355.71 N, group Mod- G2=305.27 N, group Gel-G1=466.76 N, and group Gel-G2=454.87 N. Groups Gel-G1 and Gel-G2 had significantly higher mean separation forces than groups Mod-G1 and Mod-G2. The mode of separation, independent from any group, was associated with a high frequency of adhesive failure at the metal-resin cement interface and tooth fracture was observed nearly in all specimens. No significant difference was detected between the two antibacterial adhesive system applications tested. But, due to the mode of specimen separation, this result was out of keeping with commentary. Conventional inlay retained posterior resin-bonded fixed partial dentures were found to be more retentive than modified inlay retained posterior resin-bonded fixed partial dentures. However, the simpler application procedure and the retentive performance demonstrated by the modified inlay retained posterior resin-bonded fixed partial dentures incorporating slot cavity design, had been persuading about their higher clinically admittance potential. It has been concluded that using a dentin adhesive system incorporating an antibacterial element, rather than adhesive system combined with a separate antibacterial agent application would be more favorable. Key Words: Resin-bonded fixed partial dentures; Inlays; Cavity disinfectants; Antibacterial adhesive systems.
Açıklama
Anahtar Kelimeler
Rezin-bağlı sabit bölümlü protezler, Resin-bonded fixed partial dentures, İnleyler, Inlays, Kavite dezenfektanları, Cavity disinfectants, Antibakteriyel adeziv sistemler, Antibacterial adhesive systems
