MANAGEMENT OF FRACTURED ENDODONTIC INSTRUMENT IN ROOT CANAL: A REVIEW

Abstract

With the increased practice of rotary endodontics in recent years, separated rotary nickel - titanium (NiTi) files in root canals is the most commonly reported mishap, causing lot of stress and anxiety among clinicians and patients. No clear guidelines can be drawn from the literature available because there are either too few studies of the effects of broken files on prognosis, or the few studies that have been performed involved so few patients. The prognosis is also dependent on file location, prior condition of the pulp, presence or absence of periapical lesion and many other factors. Each case is different. This paper offers a flowchart to help the general dentists and non -endodontists decide which strategy is best when faced with a broken file in root canal. The success of endodontic treatment is dictated by appropriate shaping, disinfection and three dimensional obturation of the root canal system. The success and failure of root canal treatment has three criteria; clinical, radio graphical and histological. Criteria for success and failure of endodontic treatment are different for different people. It is paramount to have clinical success to the patient, and clinical as well as radio graphical success to the dentist. The role of separated endodontic instrument on success and failure of endodontic treatment has been a dubious issue. Sometimes it may take several months, or even years, for objective evidence of failure to appear radio graphically as patients rarely experience pain. This may put the dentist in confusion in regard to the relationship between separated endodontic instrument and prognosis.