Broken Instrument Removal—Two Cases

Abstract

This paper reports two clinical aids for the removal of broken instruments in root canals using a combination of hand instrumentation and ultrasonic devices. This technique is based on two phases: hand instrumentation with stainless-steel K-file instruments for bypassing the fragments, and K-files mounted on an ultrasonic handpiece for loosening and retrieval of the broken instruments. This method offers the following advantages: conservation of the remaining dentin wall of the root canal and elimination of the necessity for surgical treatment.

Ultrasonic Vibration: Temperature Rise on External Root Surface during Broken Instrument Removal

“…D'Arcangelo et al (9) described a technique for removal of broken instruments. It consisted of hand instrumentation with stainless steel K-files alongside the broken instrument until bypassed or at least passing its coronal half.…”

Retrieval of a metallic obstruction from the root canal of a premolar using Masserann technique

“…[1] A separated instrument prevents thorough root canal cleaning and shaping apical to the level of separation and hinders the clinician from optimally preparing and obturating the entire root canal system. [23]…”

“…Success rate for instrument retrieval can be quite variable and a success rate ranging from 55% to 87% has been reported in the endodontic literature. [235]…”

Retrieval of separated instrument with instrument removal system

“…Its incidence ranges from 2% to 6% of the cases investigated. [1] The clinical outcome of the cases with fractured instruments depends on several factors such as: the position of the instrument in the canal, type of material, instrument size and canal anatomy. Failure in retrieval of the fractured instrument does not automatically result in failure of the case.…”