Pengaruh Larutan Irigasi Sodium Hipoklorit (NaOCl), Ethylendiamine Tetraacetic Acid (EDTA), Kitosan Oligosakarida (COS) dan Teknik Agitasi terhadap Pembersihan Kalsium Hidroksida pada Dinding Saluran Akar: Study in Vitro

Abstract

Introduction : Root canal treatment is the act of removing all infected pulp tissue and shaping the root canal so that it can be filled properly to prevent bacteria from re-entering the root canal. The root canal medicament commonly used is calcium hydroxide (Ca(OH)2), which aims to kill or inhibit the growth of microorganisms between visits during treatment. However, currently there is no irrigation solution and agitation technique that completely removes Ca(OH)2 from root canal walls. Chitosan oligosaccharide is a promising irrigation solution because it has high solubility and low molecular weight, biocompatibility, good bioadhesion and chelating properties.. Material and Method : Twenty four single root mandibular premolars were extracted and then root canal treatment was performed. All teeth were filled with Ca(OH)2 and divided into six treatment groups when removing Ca(OH)2, namely group A using ultrasonic activation using UltraX (Eighteeth): A1 (NaOCl 2.5% and EDTA 17%), A2 ( NaOCl 2.5% and Chitosan Oligosaccharide 2%), A3 (Chitosan Oligosaccharide 2%). While group B used XP Endo Finisher (FKG Dentaire SA Switzerland): B1 (NaOCl 2.5% and EDTA 17%), B2 (NaOCl 2.5% and Chitosan Oligosaccharides 2%), B3 (Chitosan Oligosaccharides 2%). All samples were examined using a Scanning Electrone Microscope (SEM). SEM results were assessed by scoring according to Kuga by two observers using the double-blind method. Result : The scoring results were assessed by the Paired T-Test, it was found that the results of the two observers matched. Based on the Kruskal Willis test, there were statistically significant differences in scores in the middle thirds (p = 0.005 < 0.05) and the apical thirds (p = 0.016 < 0.05). The A2 treatment group (chitosan oligosaccharides and NaOCl with ultrasonic) showed superior results compared to other groups, even in the middle thirds being able to clean thoroughly. Groups A3 and B3 using 2% oligosaccharide chitosan were not able to clean thoroughly. Conclusion : There is no irrigation solution and agitation technique that is able to completely remove calcium hydroxide from the root canal wall, including the use of 2% oligosaccharide chitosan as irrigation material. However, the combination of 2% oligosaccharide chitosan with 2% NaOCl with ultrasonic agitation technique showed promising results with markedly superior results compared to other treatment groups.