Application of Endodontic Files for the Extraction of Root Tips: A Biomechanical Investigation and Case Study

A Minimally Invasive Technique for the Retrieval of Fractured Root Tips

“…Exodontia aims to preserve the buccal and lingual or palatal cortical plates and thus should be minimally invasive [ 2 ]. Hearing a cracking sound during extraction is usual and normal, as it indicates the yielding of alveolar bone to apical pressure.…”

“…Endodontic files, particularly H-files, have been used for this purpose and can be considered as one of the most convenient techniques for retrieval. Due to the fact that they have an adhesion force when inserted into the root canal, the root fragment can be secured and removed [ 2 ]. Endodontic files are used for cleaning and shaping the root canal.…”

“…ISO size files ranging from 20 to 30 can be considered the standard for most teeth. In addition, most roots were retrieved using size 25 files [ 2 ]. In case of a few failed attempts to deliver the fragment, the file can be luted with resin-modified glass ionomer cement to gain benefit from the bonding strength [ 7 ].…”

“…Although it is a relatively simple procedure, it is a highly sensitive technique that depends on the operator's skills. The ideal tooth extraction consists of the painless removal of the tooth or tooth root, with minimal trauma to the surrounding tissues, resulting in complete healing without the creation of postoperative prosthetic problems [ 1 , 2 ]. Fractures of the tooth’s root tip during exodontia can be common in some cases, such as in teeth with irregular root morphology or with severely decayed teeth [ 2 ].…”

“…The ideal tooth extraction consists of the painless removal of the tooth or tooth root, with minimal trauma to the surrounding tissues, resulting in complete healing without the creation of postoperative prosthetic problems [ 1 , 2 ]. Fractures of the tooth’s root tip during exodontia can be common in some cases, such as in teeth with irregular root morphology or with severely decayed teeth [ 2 ]. The use of a poor extraction technique while retrieving the fractured root with conventional instruments is invasive and can lead to fracture of the buccal cortical plate, fragmentation of bone around the socket, or it can be pushed into adjacent spaces such as the maxillary sinus or inferior alveolar nerve canal [ 3 , 4 ].…”