Mauricio L. Basso, DDS; Neville J. McDonald, BDS, MS
Discipline of Endodontics University of Michigan School of Dentistry

Introduction

• The fracture of endodontic instruments during root canal mechanical instrumentation is a mishap procedural that creates a difficulty in routine root canal therapy.
• Although fractured instruments may not compromise the outcome of the treatment, the retained file fragments may impede microbial control beyond the obstruction.
• Attempts to remove fractured instruments may lead to transportation of the prepared root canal or perforation, and/or over enlargement which could lead to the weakening of the tooth.
• The separation rates of stainless steel instruments have been reported to range between 0.25% and 6%, while NiTi instruments between 1.3% and 10%. Many techniques have been used to remove separated instruments; however, it is not possible to use the same technique for every clinical case.

Summary

• The aim of this table clinic is to present an instrument retrieval technique using the diamond dusted probes from Laschal FXP System along with an ultrasonic device.
• Laschal FXP System along with ultrasonic device is a valuable alternative method to retrieve separated instruments from the root canal system. When it is not possible to retrieve the instrument from the root canal, using Laschal FXP System, it helps to create space between a file and the root canal wall, facilitating the bypassing of the separated instrument.

Acknowledgment

Dr. Carolina Cucco, Dr. Darya Dabiri, Dr. Diogo Guerreiro, Dr. Indaia Leibovicth, Dr. Jeffrey Lasner and Rackham Graduate School.

References

• Crump MC, Natkin E. Relationship of broken root canal instruments to endodontic case prognosis: a clinical investigation J Am Dent Assoc 1970;80:1341-7.3.
• Hulsman M, Schinkel I. Influence of several factors on the success or failure of removal of fractured instruments from the root canal. Endod Dent Traumatol 1999;15:252-8
• Iqbal M K, Kohlu M R, Kim J S. A Retrospective Clinical Study of Incidence of Root Canal Instrument Separation in an Endodontics Graduate Program: A PennEndo Database Study J Endod 2006; 32:1048-52
• Maradati A A, Hunter M J, Dummer P M. Management of intracanal sperated instruments. J Endod. 39: 569-81