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    Oval-shaped canal retreatment with self-adjusting file: a micro-computed tomography study
    (Springer Heidelberg, 2014) Keles, Ali; Alcin, Hatice; Kamalak, Aliye; Versiani, Marco A.
    The aim of this study was to assess the efficacy of removing the filling material from oval-shaped canals with rotary retreatment files, with or without the additional use of self-adjusting file (SAF), using micro-computed tomography. Oval-shaped canals from 20 maxillary premolars were prepared and assigned to two groups (n = 10), according to the obturation technique: cold lateral condensation (CLC) or vertical condensation (VC). Then, retreatment procedure was performed with retreatment rotary instruments followed by SAF. The specimens were scanned after each procedure and the volume of the filling material calculated. Median and interquartile range (IQR) percentages of the remaining filling material after each retreatment technique were statistically compared by Wilcoxon and Mann-Whitney U tests with a significance level of 5 %. The median percentage volume of the filling residue after rotary retreatment procedure was 1.59 (IQR = 1.26) and 0.42 (IQR = 0.86) in the CLC and VC groups, respectively (p < 0.05). After the use of SAF, the median percentage was 1.26 (IQR = 0.75) and 0.12 (IQR = 0.53) in the CLC and VC groups, respectively (p < 0.05). Statistically significant difference was also observed within the group after the additional use of SAF (p < 0.05). None of the retreatment procedures completely removed the filling material. The additional use of the SAF improved the removal of filling material after the retreatment procedure with rotary instruments. Filling material left after retreatment procedure may harbour necrotic tissue and bacteria, which could lead to a persistent disease and reinfection of the root canal system. The additional use of self-adjusting file after the conventional retreatment procedures may improve root canal cleanliness, allowing a better action of the irrigating solution.
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    Retreatment of flat-oval root canals with a self-adjusting file: An SEM study
    (Japanese Soc Dental Materials Devices, 2014) Keles, Ali; Simsek, Neslihan; Alcin, Hatice; Ahmetoglu, Fuat; Yologlu, Saim
    This study evaluated the efficacy of the Self-Adjusting File (SAF) in removing the root filling remnants and smear layer left in oval shaped root canals after using R-Endo retreatment files, by using scanning electron microscopy (SEM). Forty eight maxillary premolars were prepared and the SAF was used in all of the teeth to remove debris and smear layer. Sixteen teeth were used as control and the other 32 teeth were obturated and randomly assigned to two groups according to the retreatment procedures: R-Endo retreatment files and R-Endo retreatment files+SAF. Then, all roots were split longitudinally for SEM evaluation. Using SEM pictures, the number of dentinal tubules and the surface area covered by filling remnants were evaluated. None of the techniques removed root filling remnants and smear layer completely. Additional use of SAF after the retreatment procedures may improve root canal cleanliness in the corona] and middle thirds of oval root canals.
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    Use of Endo Vac System for Aspiration of Exudates from a Large Periapical Lesion: A Case Report
    (Elsevier Science Inc, 2015) Keles, Ali; Alcin, Hatice
    Large cyst-like periapical lesions can heal after nonsurgical root canal treatment. Decreasing the hydrostatic pressure within a periapical lesion can be achieved with the aspiration technique by using Endo Vac when there is drainage of cystic fluid through the canals. Clinical examination of a 21-year-old male patient revealed a large periapical lesion extending from the distal aspect of tooth #26 and reaching the mesial surface of tooth #22. During root canal treatment of teeth #23, #24, and #26, serous exudate drained from the root canal of tooth #24. The MacroCannula component of Endo Vac apical negative pressure irrigation system was used to aspirate the inflammatory fluid. The technique produces a vacuum effect in the periapical region through the root canal, which facilitates evacuation of large amounts of exudate. Two-year clinical and radiographic examinations revealed resolution of the mandibular radiolucency,. and the adjacent tooth #25 retained its vitality. The healing of a large periapical lesion can be achieved by the correct diagnosis and the proper treatment approach, without the need for surgery. EndoVac negative irrigation system might be useful for intracanal aspiration of exudates.