Separated instruments: manage or refer?
Damascus University, Syria
: Dent Health Curr Res
In clinical studies, the incidence of separated instrument complication has been reported to range from 0.39%–5%. Strindberg et al. found a statistically significant 19% higher failure frequency for cases in which there was instrument breakage compared with cases without breakage. A number of treatment plans for root canals with obstructing objects have been described in the literature. These depend on the location of obstructing inside the canal, if these are in the coronal, middle or apical third. Surgical techniques for the removal of either the object itself or the entire portion of the root encompassing the object have been recommended by others. Until now, no device or instrument removal technique has been described that can result in successful and conservative removal of separated instruments in the hard-to-reach areas of the canal system. The following case report describes an example of such a clinical scenario. Various approaches to manage the broken instrument (how we can bypass, retrieve or refer to specialists) by using different tools (microscope, ultrasonic retrieve kit for different company) will be presented and discussed. Also I am interested to make a live demo to all participants about retrieving separated instruments by using microscope if it is available.