Removing a fractured root tip with a hedstrom endodontic file

A common complication of exodontia is the fracture of a root tip (Figure 1). Often the root fragment is visible but withdrawing it can be troublesome. It is usually out of reach of conventional surgical instruments, such as luxators and forceps, and longer instruments such as probes cannot grip the fragment sufficiently. While bone removal can be carried out to facilitate access, a quicker and less invasive option has been reported using Hedstrom endodontic files.¹

The Hedstrom file is a round stainless steel wire ground to create a sharp-cutting flute. When rotated clockwise this file readily binds to dentine, something to be avoided during normal use in root treatment.² However, this pitfall can be used to advantage if a root tip fractures. The Hedstrom file can be ‘screwed’ into the root canal of the fractured tip and used to withdraw the fragment (Figures 2 and 3).