Retrieval of Separated Instrument using Ultrasonics in a Permanent Mandibular Second Molar: A Case Report

Clinicians are frequently challenged by endodontically treated teeth that have obstructions, such as hard impenetrable pastes, separated instruments, silver points or posts in their root canals. Intracanal separation of endodontic instruments may hinder cleaning and shaping procedures within the root canal system, with a potential impact on the outcome of treatment. Broken instruments usually prevent access to the apex and the prognosis of teeth with broken instruments in the canals may be lower than for normal ones. The prognosis of these cases mainly depends on the preoperative condition of the periapical tissues. For these reasons, an attempt to remove broken instruments should be undertaken in every case. Ultrasonics have often been advocated for the removal of broken instruments because the ultrasonic tips or endosonic files may be used deep in the root canal system. Furthermore, the use of an ultrasonic endodontic device is not restricted by the position of the fragment in the root canal or the tooth involved. This case report elaborates on retrieval of broken instrument lodged in the coronal third of the root canal using ultrasonics and dental operating microscope.