Separated Instruments, Surgical Retreatment and Non-Surgical Retreatment

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Utilizing rotary systems speed up cleaning and shaping of root canal system, but it has some compromises as well. The most important and common problem is instrument separation. Instrument separation happens because of wrong technique or manufacturer defect.

Following are two cases of instrument separation, which were managed using surgical and non-surgical techniques.

Figure-1 shows pre operative radiograph of upper left first and second premolars. Both teeth were treated before and first premolar had two separated instruments in the apical third portion of the canal. Both teeth were treated surgically and separated instruments were removed using ultrasonic tips. (Figure 2)

Figure-3 shows pre-operative radiograph of lower right first molar with a separated instrument in apical third of MB canal. The separated instrument was retrieved using ultrasonic tip and H files and tooth was successfully treated. (Figure 4)

Prevention of instrument separation is the highly recommended and following are key factors to prevent instrument separation:

  • Straight access to canals before using rotary files
  • Use of proper lubrication
  • Avoiding over usage
  • Using proper RPM and Torque recommended by manufacturer
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