Management of separated file in the root canal

Hye-Jeong Kim; Hoon-Sang Jang; Se-Hee Park; Kyung-Mo Cho; Jin-Woo Kim

doi:10.5395/JKACD.2006.31.3.161

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Kim, Jang, Park, Cho, and Kim: Management of separated file in the root canal

Case Report

Journal of Korean Academy of Conservative Dentistry

Journal of Korean Academy of Conservative Dentistry 2006; 31(3): 161-168.

Published online: 31 May 2006

DOI: https://doi.org/10.5395/JKACD.2006.31.3.161

Management of separated file in the root canal

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 29 August 2005 Revised 3 March 2006 Accepted 4 March 2006

(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.

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

Figures and Tables

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

Diagnostic intraoral radiograph.

Figure 3

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

Figure 4

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

Figure 5

Diagnostic intraoral radiograph.

Figure 6

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

Figure 7

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

Figure 8

Retrograde preparation and MTA filling.

Figure 9

Histological appearance of surgically removed tissue.

Figure 10

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

Figure 11

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

References

1. Mounce R. The heartache of separation. Dent Today. 2003. 22(4):83–85.

2. Ruddle C. Cleaning and shaping the root canal system. Pathways of the Pulp. 2002. 8th 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.

4. Hulsmann M, Schinkel I. Influence of several factors on the success or failure of removal of fractured instruments from the root canal. Endod Dent Traumatol. 1999. 15(6):252–258.

5. Ruddle CJ. Broken instrument removal. The endodontic challenge. Dent Today. 2002. 21(7):70–81.

6. Shen Y, Peng B, Cheung GS. Factors associated with the removal of fractured NiTi instruments from root canal systems. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004. 98(5):605–610.

7. Ward JR, Parashos P, Messer HH. Evaluation of an ultrasonic technique to remove fractured rotary nickel-titanium endodontic instruments from root canals: an experimental study. J Endod. 2003. 29(11):756–763.

8. Ward JR, Parashos P, Messer HH. Evaluation of an ultrasonic technique to remove fractured rotary nickel-titanium endodontic instruments from root canals: clinical cases. J Endod. 2003. 29(11):764–767.

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