Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Ağartma Yapılmış Diş Yüzeylerine Uygulanan Farklı Yüzey Tedavilerinin Tekrar Renklenmeye ve Çürük Yapıcı Mikroorganizmaların Tutunmasına Etkilerinin İn Vitro İncelenmesi
In Vitro Evaluation of the Effects on Recoloring and Retetion of Carious Microorganisms of Different Surface Treatments Applied to Bleached Enamel
Tandoğan MANGALa, Hülya ERTENa, Hanife ALTINIŞIKa, Gülçin AKÇAb, İrem ÇELİKb
aGazi Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, Ankara, TÜRKİYE
bGazi Üniversitesi Diş Hekimliği Fakültesi, Tıbbi Mikrobiyoloji ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(3):450-61
doi: 10.5336/dentalsci.2019-70744
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, ağartma tedavisinin hemen ardından mine yüzeyine topikal olarak uygulanan bazı yüzey tedavilerinin, yeniden renklenmeyi ve bazı karyojenik mikroorganizmaların mine yüzeyine tutunmasını engelleyici etkisinin değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmada; çürük, mine çatlağı, restorasyon ya da kron harabiyeti olmayan 164 adet maksiller keser insan dişi kullanıldı. Örnekler, 2 gruba ayrıldı; renk değişikliği (n=80) ve bakteri tutunması (n=84). Ağartma, 30 dk boyunca %35'lik hidrojen peroksit ağartma jeli kullanılarak gerçekleştirildi. Yüzey tedavilerinde kazein fosfopeptid-amorf kalsiyum fosfat [casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)], CPP-amorf kalsiyum fosfat florür [amorphous calcium phosphate fluoride (ACPF)], NaF, %1,23 asitlenmiş fosfat florür [acidulated phosphate fluoride (APF)], %8 arjinin ve kalsiyum karbonat profilaksi patı kullanıldı. Yüzey işlemlerinden sonra örnekler, gıda boyalarına maruz bırakıldı. Renk ölçümleri için spektrofotometre kullanıldı. Mikroorganizma tutunma deneyinin alt grubundaki örneklere, Streptococcus mutans ve Lactobacillus acidophilus ekimi yapıldı. Daha sonra örnekler gram boyası ile boyanarak, ışık mikroskobuyla X1.000 büyütmede her örneğin farklı 10 sahasında hücre sayımı yapılarak, bu sayıların ortalamaları kaydedildi. Elde edilen veriler Mann-Whitney U testi, varyans analizi (ANOVA) ve Tukey testi ile istatistiksel olarak analiz edildi. Bulgular: CPP-ACPF ve APF, yeniden renklenmenin önlenmesinde en etkili; APF, S. mutans'ların tutunmasının önlenmesinde en etkiliydi ve tüm yüzey tedavileri L. acidophilus'un tutunmasının önlenmesinde farklı derecelerde etkiliydi. Sonuç: Ağartma işleminden hemen sonra uygulanan yüzey tedavileri, yeniden renklenmenin ve S. mutans ile L. acidophilus'un tutunmasının önlenmesinde etkilidir. Bu etki, florid iyonlarının konsantrasyonu ile doğrudan ilişkilidir. Florür iyonları veya kalsiyum-fosfat eksikliği etkinliği önemli ölçüde azaltır.

Anahtar Kelimeler: Ağartma; remineralizasyon; yüzey tedavileri
ABSTRACT
 Objective: The aim of this study is to evaluate the effects of some topical surface treatments applied to the enamel surface immediately after bleaching treatment, preventing recoloring and some cariogenic microorganisms from adhering to the enamel surface. Material and Methods: A total of 164 incisor human teeth with no caries, crown destruction, enamel crack or restora¬tion were used in this study. Samples were divided into 2 groups; discoloration (n=80) and adhesion (n=84). Bleaching was performed by using 35% hydrogen peroxide bleaching gel for 30 min. under plasma arc light activation. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), CPP-amorphous calcium phosphate fluoride (ACPF), NaF, 1,23% acidulated phosphate fluoride (APF), 8% arginine and calcium carbonate prophylaxy paste were used for surface treatments. After surface treatments, samples were exposed to food colorants. Spectrophotometer used for color measurement. In adhesion groups, S. mutans and L. acidophilus were inoculated on all of the samples. After incubation, samples were gram stained and examined using microscope under X1.000 magnification. At least 10 areas were counted in all samples and mean values were recorded. The data was analyzed statistically with Mann-Whitney U test, analysis of variance (ANOVA) and Tukey test. Results: CPP-ACPF and APF were most effective in preventing discoloration, APF was most effective in preventing adhesion S. mutans, and all surface treatments were effective, variously, in preventing L. acidophilus. Conclusion: Surface treatments that applied immediately after bleaching are effective in prevention of discoloration and the adhesion of S. mutans or L. acidophilus. Efficiency is directly related with the concentration of fluoride ions. Lack of fluoride ions or calcium-phosphate reduces efficiency, significantly.

Keywords: Bleaching; remineralization; surface treatments
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