Lisans Öğrencileri Tarafından Manuel Aletlere Karşı Döner Aletler Kullanılarak Gerçekleştirilen Kök Kanal Tedavisinin Teknik Kalitesi: Bir Retrospektif Çalışma

Year 2023, Volume: 10 Issue: 2, 468 - 473, 21.08.2023

Alperen Tekin , Yelda Erdem Hepşenoğlu , Seyda Ersahan , Nur Sena Arıkan

https://doi.org/10.15311/selcukdentj.1183747

Abstract

Giriş: Kök kanal tedavisinin (KKT) teknik kalitesi sonucu etkileyebilir. Lisans eğitimi sırasında alınan eğitimin kalitesi, genel dişhekimliği pratiğinde sağlanan tedavinin kalitesi ile bağlantılı olabilir.
Amaç: Türkiye'deki bir lisans eğitimi veren diş kliniğinde döner veya manuel step-back kanal preparasyon tekniğinin kullanıldığı KKT teknik kalitesini karşılaştırmaktır. İlave olarak, bu çalışma, her iki şekillendirme sisteminde radyografik olarak sık görülen komplikasyonları karşılaştırmayı amaçlamıştır.
Gereç ve yöntemler: Dişhekimliği öğrencileri tarafından KKT uygulanan 270 hastanın diş kayıtları geriye dönük çizelge ile incelendi. 270 diş 565 kök rastgele iki gruba [(Rotasyon, n=280&Manuel, n=285)] ayrıldı. Kök kanal dolumu, dolum uzunluğunun radyografik apeksten >2 mm olması, radyodensite ve kök kanal duvarlarına adaptasyon açısından değerlendirildi. Yetersiz kök kanal dolgusu, perforasyon, basamak, transportasyon, alet kırığı gibi işlemsel hataları içeriyordu. Kategorik değişkenleri (n, %) tanımlamak için tanımlayıcı istatistikler kullanıldı ve anlamlılık düzeyi 0.05 olarak belirlendi. Bulgular: Lisans diş hekimliği öğrencileri tarafından gerçekleştirilen KKT'nin teknik kalitesi, rotasyon ve manuel grupları için sırasıyla vakaların %75'inde ve %53.7’sinde 'yeterli' olarak sınıflandırıldı (p<0.05). En yüksek işlem hataları büyük azı dişlerinde görüldü. Genel olarak prosedürel hataların oluşumu gruplar arasında anlamlı farklılık bulundu, rotasyon grubunda %6.4 ve manuel grupta %12.3 idi (p = 0.017). Bununla birlikte, manuel grupta basamak oluşumunun meydana gelmesi, rotasyon grubuna göre daha yüksekti (p = 0.007).
Sonuç: Bulgularımıza göre, lisans dişhekimliği öğrencileri tarafından döner enstrümantasyon sistemleri kullanılarak gerçekleştirilen KKT, daha yüksek teknik kaliteye sahiptir ve ayrıca manuel enstrümantasyondan daha az prosedür hatasına sahiptir.

Keywords

DÖNER ENSTÜRMANTASYON, MANUEL STEP BACK YÖNTEMİ İLE ŞEKİLLENDİRME, KÖK KANAL TEDAVİSİ, LİSANS DİŞ HEKİMLİĞİ ÖĞRENCİSİ

Technical quality of root canal treatment performed by undergraduate students using rotary instruments versus hand instruments: A Retrospective Study

Abstract

Background: The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice.
Objective: To compare the technical quality of RCT where rotary or manual step-back canal preparatory technique was employed in an undergraduate dental clinic in Turkey. Additionally, the present study aimed to compare radiographically commonly seen complications in both instrumentation systems.
Materials and Methods: Dental records of 270 patients who received RCT undertaken by dental students were investigated by retrospective chart review. 565 root canals belonging to 270 patients were randomized into two groups [(rotary, n=280, and manual hand instruments, n=285)]. Root canal obturation was evaluated on the basis of the length of obturation being >2mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as perforation, ledge, transportation, instrument separation. Descriptive statistics were used to define categorical variables (n, %) and the level of significance was set at 0.05.
Results: The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 75% and 53.7% of the cases, respectively for rotary and manual groups, respectively (p < 0.05). The highest procedural errors were seen in molars. Occurrence of procedural errors differed significantly between the groups, being 6.4% in rotary group and 12.3% in manual group (p = 0.017). However, occurrence of ledge formation was higher in manual group than that of rotary group (p = 0.007).
Conclusion: In view of our findings, RCT performed by undergraduate dental students using rotary instrumentation systems is of higher technical quality and also has fewer procedural errors than manual instrumentation.

Keywords

Rotary instrumentation, manual step-back instrumentation, root canal treatment, undergraduate dental students

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