PERBEDAAN BAHAN IRIGASI AKHIR SALURAN AKAR TERHADAP KEKUATAN PELEKATAN PUSH-OUT BAHAN PENGISI SALURAN AKAR BERBAHAN DASAR RESIN PADA DINDING SALURAN AKAR

SYLVIA WIDHIHAPSARI, drg. Diatri Nari Ratih, M.Kes., PhD., SpKG;drg. Tunjung Nugraheni, M.Kes., SpKG

2015 | Tesis-Spesialis | SP ILMU KONSERVASI GIGI

Bahan irigasi akhir pada perawatan saluran akar merupakan salah satu faktor yang berperan penting dalam kualitas adhesi antara bahan pengisi saluran akar berbahan dasar resin dan dinding saluran akar. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan penggunaan irigasi akhir EDTA 17% dan EDTA 17% diikuti klorheksidin 2% terhadap kekuatan pelekatan push out siler epoksi dan guta perca dengan siler metakrilat dan resilon pada dinding saluran akar. Penelitian ini menggunakan 28 gigi premolar mandibula pasca pencabutan. Bagian koronal dipotong sehingga menyisakan akar sepanjang 14 mm, kemudian dipreparasi sampai file #40/0,04. Spesimen dibagi secara acak menjadi empat kelompok perlakuan masing-masing 7 gigi. Kelompok IA dan IB diirigasi akhir dengan EDTA 17%, kelompok IIA dan IIB diirigasi akhir dengan EDTA 17% diikuti klorheksidin 2%. Kelompok IA dan IIA diobturasi dengan siler epoksi dan guta perca, sedangkan kelompok IB dan IIB menggunakan siler metakrilat dan resilon, kemudian disimpan dalam inkubator selama 7 hari. Spesimen dipotong horizontal pada sepertiga apikal dengan ketebalan 2 mm lalu dilakukan uji push out menggunakan universal testing machine. Data hasil penelitian dianalisis menggunakan ANAVA dua jalur dengan tingkat kepercayaan 95% (α=0,05). Uji ANAVA dua jalur menunjukkan tidak ada perbedaan kekuatan pelekatan push out antar bahan irigasi akhir EDTA 17% dan EDTA 17% diikuti klorheksidin 2%, sedangkan siler epoksi dan guta perca secara signifikan menunjukkan kekuatan pelekatan push out lebih tinggi daripada siler metakrilat dan resilon terhadap dinding saluran akar, tetapi tidak ada interaksi antara keduanya. Kegagalan kohesif dominan pada siler epoksi dan guta perca, sedangkan kegagalan adhesif dominan pada siler metakrilat dan resilon. Kesimpulan : Kekuatan pelekatan push-out menggunakan bahan irigasi akhir EDTA 17% sama dengan EDTA 17% diikuti klorheksidin 2%,namun dengan menggunakan bahan pengisi saluran akar siler epoksi dan guta perca diperoleh kekuatan pelekatan push out yang lebih besar dibandingkan siler metakrilat dan resilon.

Final irrigation is an important factor for adhesion between resin based sealer and root root canal wall. The aim of this study was to evaluate the differences of final irrigant solutions namely 17% EDTA, and 17% EDTA followed by 2% chlorhexidine on push-out bond strength of epoxy sealer and gutta-percha as well as methacrylate sealer and resilon against root canal wall. Twenty eight extracted human mandibular premolars were used in this study. The crowns were cut on cervical region to obtain root length of 14 mm, then the root canals were prepared using crown down technique to apical size # 40/0,04. These specimens were randomly divided into four groups of 7 each teeth. Group IA and IB were irrigated with 17% EDTA, group IIA and IIB were irrigated with 17% EDTA followed by 2% chlorhexidine. The root canals were obturated with epoxy sealer and guttapercha in group IA and IIA. In group I B and II B were obturated with methacrylate sealer and resilon, and then were incubated for 7 days. The specimens were horizontally sectioned into 2mm thick slice, followed by push out test using universal testing machine. All specimens were then observed under a stereo microscope (magnification of 40X) to determine the adherence failure between root canal fillings and dentinal walls. Data were analyzed with a two-way ANOVA at 95% confidence level (α=0,05). A two way ANOVA test showed that push-out bond strength between final irrigant solution of 17% EDTA, and 17% EDTA followed by 2% chlorhexidine were not different (p>0.05). Epoxy sealer and guttapercha produced significantly higher push-out bond strength than methacrylate sealer and resilon (p<0.05), however no interaction occurred between final irrigants and root canal fillings (p>0.05). The failure patterns were dominantly cohesive at the epoxy sealer and gutta percha, whereas adhesive failure at the methacrylate sealer and resilon. It can be concluded that push-out bond strength using final irrigant of 17% EDTA were not different with 17% EDTA followed by 2% chlorhexidine, while epoxy sealer and guttapercha had higher push-out bond strength than methacrylate sealer and resilon.

Kata Kunci : Kata kunci : irigasi akhir, kekuatan pelekatan push out, siler resin epoksi, siler resin metakrilat, resilon