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Management of a separated instrument beyond the apex

One of the common mishaps that may occur during shaping of the root canals is separated instrument which can hinder the proper cleaning and disinfection leaving residual tissues behind.

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Retrieve and repair

As Endodontists our daily work is an adrenaline fuel because we face new challenges on a daily basis and each case requires a strategy to fix it. Strategy before any retreatment consists of reading very carefully the preoperative X-Ray, in order to explain to the patient what is the problem, prognosis ,number of visits, possibility […]

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Apical control management with bioceramic sealer

One of the most critical steps in endodontic treatment is the filling of the root canal system. The goal of 3D obturation is to fill the entire root canal system with a biocompatible material to prevent the entry of bacteria and other irritants that can cause infection or inflammation (Camilleri J. 2015). Many techniques and […]

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Management of broken file in atresic canals

Fracture or separation of endodontic instruments is one of the main complications in our clinical practice in root canal treatment. This eventuality can negatively affect the outcome of treatment, as the blockage caused by the instrument fragments will prevent correct debridement and removal of pulp tissue, bacteria or smear layer. The prognosis in these cases […]

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Retrieval of a long fragment separated file using a loop system

The separation of a file during a root canal treatment is a complication with an incidence ranging from 0,4-5% of cases. The evidence has shown that the outcome of root canal treatment lowers if the broken file doesn’t allow a proper disinfection and obturation of the root canal space or if the file breaks at […]

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Retreatment series: Episode 3

The Root canal treatments is a way full of challenges, that may be the ANATOMY and also it may be The Dealing with the “PROCEDURAL ERRORS” in this article i will describe how I managed this Treatment Mishap. I have described in two Episodes before different approaches for Non-Surgical Root Canal Retreatment this time i […]

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Mechanical bypass of separated instruments

Check this case to see how it is possible to bypass separated instruments using FANTA Glider ST in reciprocating motion.

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CBCT guided treatment planning and management of instrument fracture in the mesial root of a second mandibular molar

Instrument fracture can be a very frustrating complication in Endodontics. Many factors determine whether a separated instrument should be removed or not from the root canal system. The aim of this case report is to highlight the usefulness of LFOV CBCT in the treatment planning of a second lower molar with a fragment in the […]

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Looks like a bullet: An iatrogenic mishap cause by tool misuse

Proper clinical practice in Endodontics requires careful and detailed knowledge on the know how of using different instruments, tools and devices used in the treatment course. Even in the simplest cases, violating the limitation of some instruments or misusing/misplacing those instruments may lead to severe iatrogenic errors which may act as a barrier against providing […]

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Management of broken files - A clinical approach - Part 2

We have discussed in the part 1 of this article how to remove broken files using ultrasonic technique ( ) but sometimes the ultrasonic (US) technique is useless when the broken file (BF) is LONG, ENGAGED or has a BIG MASS of METAL . So we need another technique to hold the broken file then pull […]

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Alternative method for removing fractured instrument: a case report

An alternative method, involving the use of an irrigation needle and cyanoacrylate adhesive, allowed the removal of the fractured instrument from inside of the canal system.  During the mechanical shaping of the root canal system, the possibility of fracture of an instrument is always present. When it occurs, the first step is  dealing with our […]

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Removal of broken instrument beyond the curvature

Management of broken instruments beyond the curvature always presents significant challenge, even for experienced clinicians. Patient was referred for retreatment of tooth #37. Tooth was diagnosed with previously initiated therapy and asymptomatic apical periodontitis. The long broken fragment of endodontic instrument in the mesial root was evident (Figure 1). In cases of broken instruments beyond the […]

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