Methods and managemnet of file retrieval. A clinician separated a instrument on the middle third of canal while doing C/S. What are the methods of file retrieval ? What are the other management options if the instrument cannot be retrieved?

1. TOPIC: METHODS &
MANAGEMENT OF FILE
RETRIEVAL
DR FARYAL AFZAL

2. Scenario:
A clinician separated a instrument on
the middle third of canal while doing C/S. What
are the methods of file retrieval ? What are the
other management options if the instrument
cannot be retrieved?

3. Introduction..
 Separation rate of stainless steel instruments is 0.25% and 6%.
 Separation rate of NiTi instrument is 1.3% and 10.0%.

4. Etiology:
 Instrument separation in endodontics occurs mainly as a result of
1. Metal fatigue.
2. Manufacturing defects.
3. Corrosion of instruments in presences of NaOCL.
4. Operator experience.
5. Rotational speed.
6. Type of tooth & Canal curvature.
7. Instruments design and technique.
8. Torque setting.
9. Type of rotational motion.
10. Absence of glide path.

5. Methods of file retrieval:
 There are 3 approaches to managing an intracanal fractured instruments…
1. Attempt to remove the instrument non-surgically or surgically.
2. Attempt to bypass it.
3. Prepare and obturate the canal with fracture instrument.

6. Attempt to remove instrument….
 Non-surgically:
 A non surgical approach should be performed if the amount of dentine removal is minimal
and does not impose risk of ledging or perforation.
1. After bypassing the separated instrument Ultrasonic files or Hedstrom files are used to
remove the segment.
2. Other devices include wedging tube, loop device , micro tweezer, plier/forceps.

7. Surgical approach…
 Surgical approach included…
1. Intentional replantation.
2. Root amputation.
3. Hemisection.
4. Apical surgery.