Farklı Kök Ucu Dolgu Materyallerinin Sitotoksik Etkilerinin ve Farklı Kök Ucu Kavite Preparasyon Tekniklerine Bağlı Olarak Apikal Sızıntı ve Kenar Uyumlarının Karşılaştırmalı Olarak Değerlendirilmesi
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A comparative evaluation of the cytotoxicity of different rootend filling materials and their apical leakage and marginal adaptation in relation to different root-end cavity preparation techniques. Hacettepe University Institute of Health Sciences, Ph.D. Thesis in Endodontics, Ankara, 2014. The aims of this study are to evaluate the sealing efficacy and marginal adaptation of MTA, CEM and Biodentine in cavities prepared by different root-end cavity preparation techniques and to analyze the cytotoxic effects of these materials. A total of 72 extracted human upper anterior teeth were used. Teeth were randomly divided as 60 teeth in experimental groups and 6 teeth each for positive and negative control groups. The crowns were removed so that the length of all roots in experimental and positive control groups was adjusted to 15 mm and their root canals were instrumented. Only specimens in experimental groups were obturated and their root-end resections were performed. Specimens in experimental groups were randomly divided into six groups including 10 specimens in each group as follows: Grup 1: Ultrasonic retrotip+MTA, Grup 2: Ultrasonic retrotip+CEM, Grup 3: Ultrasonic retrotip+Biodentine, Grup 4: Er:YAG laser tip+MTA, Grup 5: Er:YAG laser tip+CEM, Grup 6: Er:YAG laser tip+Biodentine. Microleakage was measured by fluid-filtration method. Thereafter, 6 specimen from each experimental group were randomly selected to analyze marginal adaptation. The roots were transversally sectioned in order to obtain the apical 5 mm. Next, each specimen was prepared longitudinally with burs and subsequently with sandpapers in order to expose the filling materials. Then, the specimens were prepared for scanning electron microscopy analysis. Marginal adaptation was evaluated through scoring of taken micrographs and also measured with Image J software. Human periodontal ligament fibroblasts were cultured for cytotoxicity analysis. MTA, CEM and Biodentine were prepared and after 24 hours they were applied to cells by using Millicell-96 cell culture insert plates for 24, 48 and 72 hours of incubation periods. The effect of materials on cell viability was estimated by WST-1 assay. Data were analyzed with; two-way ANOVA, Bonferroni, Kruskall-Wallis, Mann-Whitney-U, Siegel & Castellan, Spearman correlation coefficient and ANOVA with repeated measures tests. According to the results, no significant difference was found between materials regarding microleakage and marginal adaptation (p>0.05). Significantly higher microleakage and worse marginal adaptation were seen for materials placed in cavities prepared by laser tips compared with those prepared by ultrasonic tips (p<0.05). Positive correlation was found between the results of scoring and Image J analysis (r=0.596, p<0.001). Based on the results of cytotoxicity analysis, no significant differences were found between materials at each time period (p>0.05). The highest cytotoxicity for Biodentine was seen at 24 hours whereas for MTA and CEM at 72 hours (p<0.05). Different root-end cavity preparation techniques affected the microleakage and marginal adaptation of filling materials. CEM and Biodentine showed similar microleakage, marginal adaptation and cytotoxicity results to MTA.