Original Research
Volume 3 (2024), Issue 2, 11 pages.
Broken but Not Lost: Management and Retrieval of Separated Endodontic Instruments in Coronal, Middle, and Apical Thirds using unique techniques for each level of separation– A Case Series.
Manoj S 1, Pooja Prabhu 1, Vaishnavi R 1, Cherry Biyani 1, Jeevitha V 1
1 Postgraduate Student, Department of Conservative Dentistry and Endodontics, Vinayaka Mission’s Sankarachariyar Dental College, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India
Address for Correspondence:
Dr Manoj S, Postgraduate Student, Department of Conservative Dentistry and Endodontics, Vinayaka Mission’s Sankarachariyar Dental College, Salem, Tamilnadu
Contact Number - 9585327295
Email: drmanojdentist06@gmail.com
Abstract
Instrument separation is a common endodontic complication that can impede effective canal debridement and obturation. This case series describes the management of a separated instrument in different canal thirds using tailored retrieval techniques. All retrieval procedures were performed under magnification using IMAG Admatec dental loupes to enhance visualization during ultrasonic troughing and instrument retrieval. Three cases were treated using ultrasonics troughing with the loop technique, ultrasonic activation for multiple fragments, and a microtube-based extractor system. Ultrasonics enabled conservative dentin removal and fragment loosening, while the extractor system was effective in straight canals. All cases showed successful retrieval with favourable clinical and radiographic outcomes. The findings highlight the importance of selecting appropriate retrieval techniques based on fragment location and canal anatomy to achieve predictable endodontic outcomes. This case series demonstrates that successful retrieval of separated endodontic instruments is achievable through the judicious selection of retrieval techniques based on fragment location, canal anatomy, and accessibility. Ultrasonic-assisted retrieval methods proved effective and conservative for fragments located in the middle third and in cases involving multiple separated instruments, whereas the microtube-based extractor system was advantageous in straight canals with adequate access. Clinically, these cases highlight the importance of individualized treatment planning, thorough preoperative assessment, and the use of minimally invasive retrieval strategies to maximise retrieval success while preserving radicular dentin. Such a tailored approach can facilitate completion of root canal treatment, reduce procedural complications, and improve the long-term prognosis of affected teeth.
Keywords:
Instrument retrieval, Ultrasonic technique, Root canal extractor system, Loop technique, Root canal treatment.
Financial support and sponsorship
Nil
Conflicts of interest
There are no conflicts of interest.
How to cite this article: Manoj et al. Broken but Not Lost: Management and Retrieval of Separated Endodontic Instruments in Coronal, Middle, and Apical Thirds using unique techniques for each level of separation– A Case Series. Int J Endod Rehabil. 2024;3(2):1-11. https://doi.org/10.56501/Int.J.Endod.Rehabil.v3.i2.ijer0042
