Separated instrument management as a procedural accident in endodontics using the EDTA (C10H16N2O8) aided bypassing technique and the ultrasonic removal method. an in Vitro study

Abstract

Fracture of endodontic files can be considered a real concern during root canal treatment. This procedural accident is caused both by overusing instruments due to economic reasons and using an incorrect technique in root canals with difficult anatomy. A broken endodontic file does not always regard the treatment as a failure. Frequently the broken fragment can be bypassed, and the root canal treatment completed. In other cases, when the file is separated in a tooth with associated apical disease, its retrieval using ultrasonic tips is advised. Separation of a file usually occurs in molars, mainly in the mesiobuccal canal due to major curvature, poor access or small diameter. Our research was conducted to determine the in vitro efficiency of the ultrasonic removal method and the bypass technique by using 40 extracted molars with moderately curved roots. #25 K-files were deliberately broken in the middle third of mesiobuccal root canals after making a small excavation in the apical third of their active part. The results showed a significantly higher success rate of the ethylenediaminetetraacetic acid (EDTA) aided bypassing technique compared to the ultrasonic removal method.