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Professor of Higher Education in Conservative Dentistry, Faculty of Dentistry and Laboratory of Biostatistics, Clinical Research and Epidemiology, Mohammed V University in Rabat
Professor of Higher Education in Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, University Mohammed V Souissi Rabat, Avenue Allal El Fassi, Rue Mohammed Jazuli, Madinat Al Irfane, Rabat – Institutes, Morocco
Professor of Higher Education and Head of Service of Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, University Mohammed V Souissi Rabat, Avenue Allal El Fassi, Rue Mohammed Jazuli, Madinat Al Irfane, Rabat – Institutes, Morocco
The successful removal of a separated instrument from the root canal depends on various factors. The location of the broken fragment must be determined because that is commonly the most important factor in determining successful retrieval of the fragment. A variety of different methods for removing obstructions have been described in the literature. However, guidelines for the removal of a separated instrument have not been established. This review aims to describe the methodological approaches to adopt for removing an intracanal separated instrument, depending on the clinical situation, both when the fragment extends into the pulp chamber and two-thirds of the way down the root canal.
CPD/Clinical Relevance: This paper aims to describe the methodological approaches to adopt for removing an intracanal separated instrument, depending on the clinical situation.
Article
One of the most troublesome complications in endodontic therapy is having a separated instrument (SI) within the root canal space. As techniques and instrumentation have improved over time, observations have been made about the fracture rate of various endodontic instruments in root canals.
Whereas separation rates of stainless steel (SS) instruments have been reported to range between 0.25% and 6%,1,2 the separation rate of nickel-titanium (NiTi) rotary instruments has been reported to range between 1.3% and 10.0%.1,3,4,5 Numerous factors have been associated with the fracture of NiTi rotary instruments:
It has been noted that NiTi instruments frequently fracture in narrow, curved root canals.14,15 The breakage usually occurs in the apical one-third of a curved canal.13,14 The instruments usually separate by two different mechanisms: torsional fatigue or bending fatigue.16 While SS files are typically operated manually, fracture is often a result of overuse and associated with a pre-existing distortion of the instrument.17
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