The success rate of fractured instrument retrieval varies because it is dependent mainly on several factors including the visibility of the fractured instrument, the length of the fractured instrument in relation to the curvature of the canal and the techniques applied to each case. This review aims to update the present status on removal of fractured instruments to identify factors and variables that could affect the success of fractured instrument retrieval based on both the preparation techniques and the instrument retrieval techniques. On the other hand, future directions of fractured instrument retrieval should focus on management of nonvisible fractured instruments since the removal of those instruments is deemed unpredictable with the current techniques, whereas the removal of visible fractured instruments is considered predictable now. Another possible direction of it is that there might be no more instrument fracture due to possible significant changes in the root canal preparation technique which may dispense with the use of rotary instruments.

The purpose of this randomized, double-blind, controlled study was to assess the effect of antibiotic premedication on pre treatment and post opertive pain after endodontic treatment. Forty two patients with symptomatic irreversible pulpitis were randomized and allocated to experimental and placebo groups where the experimental group received the antibiotic premedication. Degree of pain was measured by the number of analgesics needed in addition to a four step pain scale before initiation of endodontic treatment and at time intervals of 6, 12, 24, 48 and 96 hours. We found that no statistical significant difference was detected at the pretreatment time interval. Statistical significant difference was groups after 24 hours of endodontic treatment where the experimental group reported less degree of post operative pain than the placebo group. No statistical significance difference detected at other time intervals. we concluded that antibiotic premedication could be prescribed to lessen the degree of post operative. pain after endodontic treatment