Management of Separated Endodontic Instrument in Mandibular Second Molar with Bypass Technique

Abstract

One of the most common mishaps in root canal treatment is a separated endodontic instrument. Bypass technique is an effective alternative besides file retrieval while clinical conditions have lack of access and visibility. Other than, this technique gives a more conservative outcome because it prevents more dentin removal. The aim of this case report was to describe management of separated endodontic instruments in the mandibular second molar with bypass technique during endodontic treatment. A 3,5 mm F1 ProTaper Hand Use file was separated in the mesiobuccal canal of the mandibular second molar. Radiograph examination was taken to make sure the level of fragment. Bypass was performed with #10 until #25 K-File to pass the separated instrument through the gap between it and the root canal wall. Obturation has been done with gutta percha and resin-based sealer using cold lateral condensation technique. Direct restoration was chosen as final restoration after 6 days follow up. Bypass technique can be performed as management of separated instrument considering the risks involved fragment extrusion to apical region, secondary separated instrument, and conservative aspect.