Ca(OH)2 içerikli gütaperka ve Ca(OH)2 patının apeksifikasyon tedavisindeki etkinliklerinin klinik ve dijital radyografi ile karşılaştırılması

Abstract

The aim of this study was to present a clinical and radiographic comparison of the efficiency of gutta-percha points containing calcium hydroxide and calcium hydroxide paste in apexification treatment of immature upper central incisors. The study also sought to identify densitometric changes in apical regions of treated teeth on radiographs taken with the use of paralleling cone technique and step-wedge.The study included 22 upper central incisor teeth of 16 children (7 girls, 9 boys) between the ages of 8-11. Of these, 12 teeth were treated with CHPP and 10 were treated with CHP. Clinical symptoms that could affect the formation of apical barrier and apexification durations were noted. Density measurements were done by using PSPL system with three-month periods. The overall success of the treatment materials was evaluated according to clinical and radiographic success criterias.At the end of apexificiation treatments, the success rates of CHHP and CHP were 92 percent and 100 percent respectively. No significant statistical difference was found between the groups in terms of general success.The study showed no significant relationship of the success of apexification treatment to type of trauma, post-trauma period, pre-operative abscess and acute symptoms and reinfections during the treatment.Apexification treatment was completed in a 9.6-month mean time (sd±2.4) in the CHP group, and it was completed in a 9.54-month mean time (sd±2.5) in the CHPP group. No important statistical difference was observed between the two groups in terms of treatment time. The study revealed that gender, age, trauma type, post-trauma period, pre-operative abscess and reinfections during the treatment did not affect apexification time. However, pre-operative acute symptoms such as night pain, spontaneous pain and extreme percussion sensitivity extended the treatment time on a statistically meaningful level.The barriers were located apically in 100 percent of the treated teeth in CHPP group and 90 percent of the teeth in CHP group. No statistical significant difference was observed between the groups in terms of apical barrier location.Densitometric analysis? of apical regions of the successfully treated 19 teeth taken with the help of paralleling cone technique and step-wedge in a period of 3 months revealed that pre-operative mean optic density was 7.0 mmAl and post-operative mean optic density was 4.98 mmAl. These results showed statistically significant density changes between pre-operative and post-operative values. However, there was no statistical difference between the treatment groups in terms of optic density values of the apical barriers.No statistical significant difference was observed between CHPP and CHP in terms of overall success of apexification treatment. On the other hand, the use of CHPP in apexification treatments of immature teeth has several advantages for both the patient and the doctor in terms of clinical easiness. So, CHPP usage for this treatment protocol can be recommended.Optical density values of the newly formed apical barrier showed meaningful changes throughout the treatment and the final average value read was 4.98 mmAl. These values can be used as important criteria for more advanced studies in the diagnosis of barrier formation.