Diş apselerinde gümüş anot uygulaması

Abstract

-oz Saf gümüş metalinin antibakteriyel etkisi vardır, fakat elektrik akımı ile kombine edildiği zaman bu etki yaklaşık yüz defa artar. Doku uyumluluğu ve düşük toksisitesi gösterilmiş olan gümüş, anot, antimikrobik olarak ortopedistler tarafından derin kemik lezyonlarında kullanılmış ve başarılı sonuçlar elde edilmiştir. Bu literatür çalışmaları baz alınarak dişlerin enfekte kök kanallarını gümüş anot ile dezenfekte etmek ve bu sırada enfekte kök kanalları içerisinden elde edilen mikroorganizmaların antibiyotik duyarlılıklarını değerlendirerek, akut diş apselerinde ilk tercih edilebilecek antibiyotikleri tespit etmek hedeflendi. Yaşları 16 ile 60 arasında değişen 46 adet hastanın 58 adet kronik enfeksiyonlu dişinin kök kanallarına birer gümüş elektrot uygulandı. İçerisinde küçük bir gümüşlü saat pili bulunan protez ağıza yerleştirildi, pozitif kutubu diş içerisindeki elektrota temas ettirildi, 4 gün boyunca hastanın bu protezi kullanması sağlandı. Gümüş anot uygulamasından önce, sonra ve birer hafta ara ile iki defa olmak üzere dişin kök kanalından alınan materyalin kültürü yapıldı. Uygulamayı takiben 58 dişin 44 tanesinin (%75.8) kök kanalından bakteri üretilemedi, bunlardan 17 tanesinde radyolojik düzelme görüldü, 14 hastanın ise kök kanalında bakteri üremesi devam etti. Bunlardan 4 ünde akut enfeksiyon geliştiği için dişler çekildi. Ellisekiz dişten toplam olarak 90 bakteri susu izole edildi ve incelendi. Bunlardan 73 (%81) tanesi mecburi anaerop, diğer 17 (%18.9) tanesi ise fakültatif anaerop idi. En sık rastlanan mikrorganizmalar mecburi anaerobik streptokoklar ve Prevotellalardı. Antibiyotik duyarlılık testlerine göre üreyen mikroorganizmaların amoxicillin + clavulanic acid ve makrolid grubu antibiyotiklere daha duyarlı oldukları tespit edildi. Anahtar sözcük: Gümüş anot, endodonti, amoxicillin + clavulanic acidIV- ABSTRACT SILVER ANODE TREATMENT ON DENTAL ABSCESSES Pure silver metal has antibacterial effect enhances approximately 100 times when silver is combined with positive pole of a low electric current. Silver anode was used by ortopaedists in deep bone infections as an antimicrobic agent which was postulated it's low toxicity and tissue compatibility. In this study, to disinfect root canals of teeth by a silver anode and to predict the most effective antibiotic(s) in dental abscesses was aimed. Fifty eight teeth of 46 patients (age range 16-60) was treated a silver electrode. A removable applience that was included a silver watch battery was applied into mouth throughout 4 succesive days. Microbiological detection was made before, after and 2 times of one week intervals of silver anode procedure. Disinfection was provided in 44 of 58 (75.8%) teeth. A satisfactory radioopacity was demonstrated in 17 teeth. Disinfection was not obtained in 1 4 teeth, 4 of them were extracted because of acute infection. Totally 90 strains were isolated. 73 strains (81%) was strickly anaerobic, other 17 (18.9%) was facultative anaerobic. Most prevalan strains were anaerobic streptococci and Prevotella sp.. Amoxicillin + clavulanic acid and macrolid group was found to be more effective on all isolates. Keywords: Silver anode, endodontics, amoxicillin + clavulanic acid -IV-

IV- ABSTRACT SILVER ANODE TREATMENT ON DENTAL ABSCESSES Pure silver metal has antibacterial effect enhances approximately 100 times when silver is combined with positive pole of a low electric current. Silver anode was used by ortopaedists in deep bone infections as an antimicrobic agent which was postulated it's low toxicity and tissue compatibility. In this study, to disinfect root canals of teeth by a silver anode and to predict the most effective antibiotic(s) in dental abscesses was aimed. Fifty eight teeth of 46 patients (age range 16-60) was treated a silver electrode. A removable applience that was included a silver watch battery was applied into mouth throughout 4 succesive days. Microbiological detection was made before, after and 2 times of one week intervals of silver anode procedure. Disinfection was provided in 44 of 58 (75.8%) teeth. A satisfactory radioopacity was demonstrated in 17 teeth. Disinfection was not obtained in 1 4 teeth, 4 of them were extracted because of acute infection. Totally 90 strains were isolated. 73 strains (81%) was strickly anaerobic, other 17 (18.9%) was facultative anaerobic. Most prevalan strains were anaerobic streptococci and Prevotella sp.. Amoxicillin + clavulanic acid and macrolid group was found to be more effective on all isolates. Keywords: Silver anode, endodontics, amoxicillin + clavulanic acid -IV-