Surgical Manual Removal of Fractured Endodontic Instrument in the Apical Third of Maxillary Premolar: Case Report Remoção Manual não Cirúrgica de Instrumento Endodôntico Fraturado no Terço Apical de Pré-Molar Superior: Relato de Caso
Article Sidebar
Published:
Jun 12, 2020
Keywords:
Instrument Fracture., Endodontic Treatment., Periradicular Lesion., Instrument Removal.
Main Article Content
Abstract
Accidental fracture of an instrument during endodontic treatment can
occur due to lack of dental anatomy knowledge, use of inadequate
instruments or technical failure of the operator. The aim of the present
study is to present a case report of instrument fragment removal from
a superior premolar. The fragment was identified to be in the apical
third of the buccal root. The first attempt to remove the instrument
was made without success. After 15 days, in a new attempt, the
instrument was removed with the aid of an ultrasonic endodontic tip.
The intracanal medication between sessions was calcium hydroxide,
camphorated paramonochlorophenol and propylene glycol. After
more 15 days, the tooth was asymptomatic and was filled by lateral
condensation. Thus, the patient was referred for definitive restoration.
After 3 months, it was observed radiographically the regression of the
periradicular lesion. In conclusion, the removal of the fragment proved
to be an efficient option, providing the maintenance of the tooth with
no signs and symptoms.
Article Details
How to Cite
Volpato Marques Tookuni, I., Capitanio, M., Jefferson Sevila Versan, H., & Sergio Endo, M. (2020). Surgical Manual Removal of Fractured Endodontic Instrument in the Apical Third of Maxillary Premolar: Case Report. Naval Dental Jounal, 47(1), 33-38. https://doi.org/10.29327/25149.47.1-5
Section
Case Reports
References
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clinical use. J Endod. 2004 Oct 30(10):722-5.
10. Serefoglu B, Kaval ME, Micoogullari Kurt S, Çalişkan MK.
Cyclic Fatigue Resistance of novel glide path instruments
with different alloy properties and kinematics. J Endod. 2018
Sep 44(9):1422-24.
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stress and cyclic fatigue resistance of ProFile GT and
ProFile GT Series X rotary nickel-titanium files. J Endod. 2009
Mar 35(3):404-7
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types of rotary nickel-titanium files in a dynamic model. J
Endod. 2006 Jan 32(1):55-7.
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2013 Apr 214(8):395-400.
19. McGuigan MB, Louca C, Duncan HF. The impact of fractured
endodontic instruments on treatment outcome. Br Dent
J. 2013 Mar 214(6):285-9.
20. Garg H, Grewal MS. Cone-beam Computed Tomography
Volumetric Analysis and Comparison of Dentin Structure
Loss after Retrieval of Separated Instrument by Using
Ultrasonic EMS and ProUltra Tips. J Endod. 2016 Nov
42(11):1693-98.
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G, Hørsted Bindslev P, Reit C, editors. Textbook of
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22. Fu M, Zhang Z, Hou B. Removal of broken files from root
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microscope: a retrospective analysis of treatment outcome. J
Endod. 2011 May 37(5):619-22.
23. 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 Nov 98(5):605-10.
24. Mandel E, Adib-Yazdi M, Benhamou LM, Lachkar T, Mesgouez
C, Sobel M. Rotary Ni-Ti profile systems for preparing
curved canals in resin blocks: influence of operator on instrument
breakage. Int Endod J. 1999 Nov 32(6):436-43.
25. Masserann J. “Entfernen metallischer Fragmente aus Wur38
Revistazelkanälen” (Removal of metal fragments from the root canal).
J Br Endod Soc. 1971 Autumn;5(3):55-9.
26. Ruddle CJ. Micro-endodontic nonsurgical retreatment.
Dent Clin North Am. 1997 Jul 41(3):429-54.
27. 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 Nov 29(11):764-7.
instruments to endodontic case prognosis: a clinical investigation.
J Am Dent Assoc. 1970 Jun 80(6):1341-7.
2. Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B,
Engström B. Retreatment of endodontic fillings. Scand J Dent
Res. 1979 Jun 87(3):217-24.
3. Spili P, Parashos P, Messer HH. The impact of instrument
fracture on outcome of endodontic treatment. J Endod. 2005
Dec 31(12):845-50.
4. Parashos P, Messer HH. Rotary NiTi instrument fracture
and its consequences. J Endod. 2006 Nov 32(11):1031-43.
5. Parashos P, Messer HH. Questionnaire survey on the use
of rotary nickel-titanium endodontic instruments by Australian
dentists. Int Endod J. 2004 Apr 37(4):249-59.
6. Suter B, Lussi A, Sequeira P. Probability of removing fractured
instruments from root canals. Int Endod J. 2005 Feb
38(2):112-23.
7. Gambarini G. Cyclic fatigue of ProFile rotary instruments
after prolonged clinical use. Int Endod J. 2001 Jul 34(5):386-9.
8. McGuigan MB, Louca C, Duncan HF. Endodontic instrument
fracture: causes and prevention. Br Dent J. 2013 Apr
214(7):341-8.
9. Parashos P, Gordon I, Messer HH. Factors influencing defects
of rotary nickel-titanium endodontic instruments after
clinical use. J Endod. 2004 Oct 30(10):722-5.
10. Serefoglu B, Kaval ME, Micoogullari Kurt S, Çalişkan MK.
Cyclic Fatigue Resistance of novel glide path instruments
with different alloy properties and kinematics. J Endod. 2018
Sep 44(9):1422-24.
11. Kramkowski TR, Bahcall J. An in vitro comparison of torsional
stress and cyclic fatigue resistance of ProFile GT and
ProFile GT Series X rotary nickel-titanium files. J Endod. 2009
Mar 35(3):404-7
12. Yao JH, Schwartz SA, Beeson TJ. Cyclic fatigue of three
types of rotary nickel-titanium files in a dynamic model. J
Endod. 2006 Jan 32(1):55-7.
13. Chhina H, Hans MK, Chander S. Ultrasonics: A novel
approach for retrieval of separated instruments. J Clin Diagn
Res. 2015 Jan 9(1):18-20.
14. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting
the long-term results of endodontic treatment. J Endod.
1990 Oct 16(10):498-504.
15. Siqueira JF Jr. Aetiology of root canal treatment failure:
why well-treated teeth can fail. Int Endod J. 2001 Jan 34(1):1-
10.
16. Koç C, Kamburoğlu K, Sönmez G, Yılmaz F, Gülen O, Karahan
S. Ability to detect endodontic complications using
three different cone beam computed tomography units with
and without artefact reduction modes: an ex vivo study. Int
Endod J. 2019 May 52(5):725-36.
17. Panitvisai P, Parunnit P, Sathorn C, Messer HH. Impact of
a retained instrument on treatment outcome: a systematic
review and meta-analysis. J Endod. 2010 May 36(5):775-80.
18. McGuigan MB, Louca C, Duncan HF. Clinical decision-
-making after endodontic instrument fracture. Br Dent J.
2013 Apr 214(8):395-400.
19. McGuigan MB, Louca C, Duncan HF. The impact of fractured
endodontic instruments on treatment outcome. Br Dent
J. 2013 Mar 214(6):285-9.
20. Garg H, Grewal MS. Cone-beam Computed Tomography
Volumetric Analysis and Comparison of Dentin Structure
Loss after Retrieval of Separated Instrument by Using
Ultrasonic EMS and ProUltra Tips. J Endod. 2016 Nov
42(11):1693-98.
21. Machtou P, Reit C. Non-surgical retreatment. In: Bergenholtz
G, Hørsted Bindslev P, Reit C, editors. Textbook of
endodontology. 1st ed. Oxford: Blackwell Munksgaard Ltd;
2003. p.300-10.
22. Fu M, Zhang Z, Hou B. Removal of broken files from root
canals by using ultrasonic techniques combined with dental
microscope: a retrospective analysis of treatment outcome. J
Endod. 2011 May 37(5):619-22.
23. 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 Nov 98(5):605-10.
24. Mandel E, Adib-Yazdi M, Benhamou LM, Lachkar T, Mesgouez
C, Sobel M. Rotary Ni-Ti profile systems for preparing
curved canals in resin blocks: influence of operator on instrument
breakage. Int Endod J. 1999 Nov 32(6):436-43.
25. Masserann J. “Entfernen metallischer Fragmente aus Wur38
Revistazelkanälen” (Removal of metal fragments from the root canal).
J Br Endod Soc. 1971 Autumn;5(3):55-9.
26. Ruddle CJ. Micro-endodontic nonsurgical retreatment.
Dent Clin North Am. 1997 Jul 41(3):429-54.
27. 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 Nov 29(11):764-7.