Therapeutic Options for the Management of Fractured Instruments
Fig. 4.1 Nonrestorable roots of a mandibular second molar with a fragment in the apical third of the distal root. Tooth extraction is the treatment of choice in this case…
Endodontics
Complications During Attempts of Retrieval or Bypassing of Fractured Instruments
Fig. 7.1 (a) Preoperative radiograph. (b) Fractured instrument in the apical third of the curved distal root of a first mandibular molar. (c) Root perforation and creation of “iatrogenic” canal…
Factors Affecting Intracanal Instrument Fracture
Factors affecting intracanal instrument fracture Operator related Skill, proficiency, judgment Anatomy related Access cavity Root canal anatomy Instrument related Material Design Manufacturing process and errors Technique/use related Motors operating parameters…
Introduction: Prevalence of Fractured Instruments
Fig. 1.1 Fragments of various endodontic instruments Fig. 1.2 (a) Fragment of an irrigation needle in the mesiobuccal root canal of a maxillary molar. (b) Fragment of the notched end…
Mechanisms of Instrument Failure
Fig. 3.1 Image showing H-files discarded after clinical use due to plastic deformation of the cutting tip Fig. 3.2 Distribution of fractured and plastically deformed instruments within different ISO sizes…
Prognosis of Root Canal Treatment with Retained Instrument Fragment(s)
Study Lesiona No lesion Healing (%) Effect on healing Strindberg (1956) 2/4 9/11 11/15 (73%) Overall 19% reduction (although lower when lesion is present) Grahnén and Hansson (1961) NR NR…
Parameters Influencing the Removal of Fractured Instruments
Fig. 5.1 (a) Preoperative radiograph of a mandibular right first molar with a fragment in the middle third of the mesial root. (b, c) Operative microscope photographs of the pulp…
Prevention
Steps Procedure First Ten vigorous strokes in a scouring sponge soaked in 0.2% chlorhexidine solution Second 30-min presoak in an enzymatic cleaning solution Third 15-min ultrasonication in the same solution…
Comparative Evaluation of Techniques and Devices for the Removal of Fractured Instruments
Author(s) Study design and sample size Methods, devices, instruments, techniques, and protocol used Microscope Definition of success Success rate Shiyakov and Vasileva (2014) In vivo (n = 26) Ultrasonics Yes…
Complications
Fig. 4.1 Large MODB pin-retained amalgam restoration. The loss of original occlusal anatomy landmarks and pulp canal space calcification will make this a more challenging tooth to access for root…
Relationship
Fig. 10.1 Anatomic relationship between pulp and periodontium In case of endodontic lesions, the pathway of inflammation is through the apical foramen, furcation canals, and lateral accessory canals to the…
due to Root Canal Filling Procedures
Fig. 6.1 (a) Micro-computed tomography axial section of a tooth with the root canals filled. The material appears in black color and shows a good filling of the root canals….
Due to Medicaments
Fig. 7.1 NaOCl extrusion (Courtesy of Dr. Daniel OTT) 7.2.2 Probable Aetiological Factors 1. Wide apical foramina 2. If the apical constriction is destroyed probably during root canal instrumentation…
Diagnosis and Treatment Planning
Medical/Dental history Past/recent treatment, drugs Chief complaint (if any) How long, symptoms, duration of pain, location, onset, stimuli, relief, referred, medications Clinical exam Facial symmetry, sinus tract, soft tissue, periodontal…
of Radiographic Interpretation
Fig. 2.1 Periapical radiographic images obtained by intraoral solid-state sensors, used for diagnosis, odontometry, and follow-up 2.2 Digital Radiography Digital intraoral receptors have several advantages compared to conventional film-based imaging,…
of Local Anaesthesia in Endodontics
Fig. 3.1 Indirect view of palate where 4% articaine with 1:80,000 adrenaline was administered. Sloughing following vasoconstrictor induced ischemia is a more likely reason than the anesthetic per se When…
in Geriatric Patient
Fig. 11.1 (a, b) Male patient, 70 years old, no systemic problem, strong attrition, secondary dentine formation and calcifications in pulp chamber, and vertical dimensional loss. This sort of clinical…
to Reduce the Risk of Reinfection in Endodontics
Poorer prognosis Better prognosis Secondary infection Primary infection Long-standing infection Presence of fistulae No historical or current oral/endodontic communication Lack of coronal seal/insufficient residual tooth structure Sufficient tooth structure…
Complications
Fractured instrument (can it be bypassed?) Yes No (consider the location) Continue biomechanical preparation. Do not attempt to remove the fractured part of the instrument Apical third Middle/coronal third …
of Endodontic Surgery
Fig. 9.1 Gingival recession following intrasulcular incision in the area of maxillary central incisor (PFM crown) Separation of the wound margins may occur within the first week after surgery. This…