Comparison of the Different Techniques to Remove Fractured Endodontic Instruments from Root Canal Systems

Abstract

Objectives: To evaluate the success of certain methods that can be used in the removal of separated instruments from different levels in curved and straight canals. Methods: Instrument removal attempts were undertaken on 63 straight and 30 curved canals containing a pre-fractured instrument using the ultrasonics under the visualization of an operating microscope or conventional methods. In straight canals, a Masseran Kit was additionally used to these techniques. The success of instrument removal in relation to the techniques used and the location of the fragments in the root canal were evaluated. Successful treatment was defined by the removal or complete by passing of the fragments. Results: The overall success rate was found 93.3% with ultrasonics and 66.6% when only conventional methods were used in curved canals. In straight canals, also the success rate was the highest with ultrasonics (95.2%). This was followed by conventional method (80.9%) and the least by Masserann Kit (47.6%). When the success rate was investigated according to the location of the broken instruments, the lowest rate was found in the apical third of root canal. Conclusions: Location of the fragment and the shape of the root canal influence the success of fractured instrument management. Ultrasonics under the visualization of an operating microscope was found to be an effective removal method.

Effectiveness of different irrigation systems in the presence of intracanal‐separated file

“…However, during fragment retrieval, root fracture or perforation may occur after extreme thinning of the root canal walls (Lertchirakarn, Palamara, & Messer, 2003). Retrieval of the separated fragment is unlikely to occur when it has separated near the apical region (Gencoglu & Helvacioglu, 2009). If an SF cannot be retrieved, and the risk of complication is considered, adequate preparation and obturation can be achieved by accessing the apical region of the fragment after first by-passing it (Nevares, Cunha, Zuolo, & Bueno, 2012).…”

Effects of ultrasonic removal of fractured files from the middle third of root canals on dentinal cracks: a micro‐computed tomography study

“…Several techniques and devices have been used for the removal of fractured instruments from root canals (H€ ulsmann 1990, Okiji 2003, Alomairy 2009). Amongst these, the use of ultrasonic techniques combined with a dental operating microscope have been reported consistently to be successful and safe (Ward et al 2003, Suter et al 2005, Gencoglu & Helvacioglu 2009).…”

Conservative management of intracanal separated endodontic instruments – treatment decisions and related factors

“…Root canal system anatomy incl. diameter, length, curvature of the root canal, root canal morphology and dentin thickness (3,(11)(12)(13)(14)(15): In general, curved canals present a higher risk for iatrogenic events than straight root canals. The higher the angle of root curvature is, the more difficult it gets to create a platform around the coronal part of the separated fragment, because of the insufficient dentin thickness (3).…”