J Korean Acad Conserv Dent.  2006 May;31(3):161-168. 10.5395/JKACD.2006.31.3.161.

Management of separated file in the root canal

• Kim HJ
• Jang HS
• Park SH
• Cho KM
• Kim JW

• KMID: 2175815
• DOI: http://doi.org/10.5395/JKACD.2006.31.3.161

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.

Keyword

Separation; Management; Ultrasonic instrument; Microscope

MeSH Terms

Dental Pulp Cavity*
Root Canal Preparation
Ultrasonics

Figure

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  Figure 1 Diagnostic intraoral radiograph (a). Separated file in the mesial root isthmus (b, c) and remove it using ultrasonic device under microscope (d).

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  Figure 2 Diagnostic intraoral radiograph.

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  Figure 3 File separation in the root canal (a, b) and remove using ultrasonic device under microscope (c).

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  Figure 4 Master cone fitting and canal filling. Arrow indicates thinned dentinal wall.

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  Figure 5 Diagnostic intraoral radiograph.

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  Figure 6 File separation in the canal (a) and root perforation (b). Canal obturation after bypassing with hand file (c, d).

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  Figure 7 After tooth extraction, C-shaped root apex and root perforation were investigated.

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  Figure 8 Retrograde preparation and MTA filling.

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  Figure 9 Histological appearance of surgically removed tissue.

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  Figure 10 After intentional replantation (a), 3-month recall (b), 6-month recall (c) radiograph.

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  Figure 11 Diagnostic intraoral radiograph (a). By-passing with hand file (b) and canal obturation (c, d). 30-month recall (e): tooth is symptomless.

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