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Management of separated file in the root canal


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Management of separated file in the root canal

Article information

Restor Dent Endod. 2006;31(3):161-168
Publication date (electronic) : 2006 May 31
doi : https://doi.org/10.5395/JKACD.2006.31.3.161
Hye-Jeong Kim, Hoon-Sang Jang1, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Department of Conservative Dentistry, College of Dentistry, Kangnung National University, Korea.
1Department of Conservative Dentistry, College of Dentistry, Wonkwang University, Korea.
Corresponding Author: Jin-Woo Kim. Department of Conservative Dentistry, College of Dentistry, Kangnung National University, Jibyun-Dong, Kangnung, Kangwon, Korea, 210-702. Tel: 82-33-640-3189, Fax: 82-33-640-3113, mendo7@kangnung.ac.kr
Received 2005 August 29; Revised 2006 March 03; Accepted 2006 March 04.

Abstract

During root canal preparation procedures, the potential for instrument separation is always present. Files, a lentulo, a Gates-Glidden (GG) bur or any manufactured obstruction can be left behind in the canal. Nickel-titanium (NiTi) rotary files are in common usage in these days. Despite their undeniable advantages, there is a potential risk of separation within the canals. It is very rapid, unpredictable, and creates a great deal of stress for the practitioner.

When an endodontic instrument separates, the best option is to remove it. Ultrasonic instruments and microscopes have improved the success rate for removing separated instruments. But it is difficult and not always possible. Therefore prevention is the key.

In this case report, several management methods of separated file in the canal are presented.

Keywords: Separation; Management; Ultrasonic instrument; Microscope

References

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2. Ruddle C. Cleaning and shaping the root canal system. Pathways of the Pulp 2002. 8th edth ed. St. Louis: Mosby; 231–292.
3. Nagai O, Tani N, Kayaba Y, Kodama S, Osada T. Ultrasonic removal of broken instruments in root canals. Int Endod J 1986. 19(6)298–304.
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Article information Continued

Copyright © 2006 Korean Academy of Conservative Dentistry
(open-access) :

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1

Figure 1

Diagnostic intraoral radiograph (a). Separated file in the mesial root isthmus (b, c) and remove it using ultrasonic device under microscope (d).

Figure 2

Figure 2

Diagnostic intraoral radiograph.

Figure 3

Figure 3

File separation in the root canal (a, b) and remove using ultrasonic device under microscope (c).

Figure 4

Figure 4

Master cone fitting and canal filling. Arrow indicates thinned dentinal wall.

Figure 5

Figure 5

Diagnostic intraoral radiograph.

Figure 6

Figure 6

File separation in the canal (a) and root perforation (b). Canal obturation after bypassing with hand file (c, d).

Figure 7

Figure 7

After tooth extraction, C-shaped root apex and root perforation were investigated.

Figure 8

Figure 8

Retrograde preparation and MTA filling.

Figure 9

Figure 9

Histological appearance of surgically removed tissue.

Figure 10

Figure 10

After intentional replantation (a), 3-month recall (b), 6-month recall (c) radiograph.

Figure 11

Figure 11

Diagnostic intraoral radiograph (a). By-passing with hand file (b) and canal obturation (c, d). 30-month recall (e): tooth is symptomless.