Abstract Title

Management of separated instruments by file bypass technique

Lead Author Affiliation

Endodontics

Lead Author Status

Graduate Endodontics

Expected Graduation Date

2019

Presentation Category

Endo

Introduction/Context/Diagnosis

Instrument separation within the root canal is an unwanted and frustrating complication. Two cases are reported here describing the management of a broken instrument by file bypass technique.

Methods/Treatment Plan

The first case is with a 20 year old female patient who presented to the Endo Clinic with a previously initiated mandibular molar with a broken rotary instrument in a distolingual root. The second case is with a 54 year old female patient with a previously initiated mandibular premolar with a retained K file fragment in lingual canal. Due to the risk of removing unnecessary dentin, a bypass technique was performed. The canals were cleaned and shaped with K files. They were obturated in warm vertical condensation fashion.

Results/Outcome

Both patients were asymptomatic after the treatment.

Significance/Conclusions

The best way to manage instrument separation is to prevent such instances. Understanding the canal anatomy and safe use of the instruments with modern techniques may prevent such complications. However, even when these precautions are made, instrument separation may still occur. Removal of a fractured instrument may not be feasible or non-ideal because of the location and risk involved in the process. In these cases, bypassing the instrument is a valid alternative, which can lead to favorable outcomes as presented in these case reports.

Comments/Acknowledgements

The author denies any conflicts of interest related to this study.

Format

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Management of separated instruments by file bypass technique

Instrument separation within the root canal is an unwanted and frustrating complication. Two cases are reported here describing the management of a broken instrument by file bypass technique.