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Article: Volume 44 Number 10 Page 993 - November 2017

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  Dent Update 2017; 44: 993-997

Endodontics:  Surgical Endodontics to Manage a Separated Instrument: A Case Report

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Abstract: Various iatrogenic mishaps can impede adequate biomechanical preparation of the root canal system. Instrument separation can be treated by orthograde retreatment, with or without instrument removal, endodontic surgery or extraction. The aim of this case report is to describe a minor surgical procedure to resect an infected root containing a separated instrument. A fractured instrument was detected in the mesiobuccal root of the maxillary first molar extending beyond the apex. This fractured instrument was serving as a niche for infection and formation of a sinus tract. The fractured instrument could not be retrieved through the root canal, hence the root canal was obturated up to the fractured instrument and the apical half of the mesiobuccal root was resected surgically. At the two years recall the clinical and radiographic outcome was considered favourable.

Clinical relevance: Endodontic surgery, while classically being considered as the last resort, becomes important when orthograde retreatment fails to remove the cause of persisting infection.

Author notes: Tahir Yusuf Noorani, MResDent, Senior Lecturer, Conservative Dentistry Unit, Nik Rozainah Nik Abdul Ghani, MSc(Clinical Endo), Senior Lecturer, Conservative Dentistry Unit, Jawaad Ahmed Asif, MOMS, Senior Lecturer, Oral and Maxillofacial Surgery Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia and Irshad Abdul Rahim, DDS, General Dental Practitioner, Dental Department, Al Muhaisnah Polyclinic, Dubai, United Arab Emirates.

Objective: To demonstrate the use of surgical endodontics to treat an iatrogenic mishap, which was the cause of persistent infection, effectively.