Technique and Management of an Iatrogenic Defect Caused During Retrieval by Treating It as A Canal Extension: A Case Report

A R Vivekananda Pai

doi:10.21276/aohdr.1897

Abstract

Masserann technique is one of the methods suggested for retrieval of separated instruments. However, its application in posterior teeth is risky, difficult, and clinically challenging. This case report illustrates successful application of Masserann technique to retrieve a separated instrument from the middle third of a mesial canal of a mandibular second molar and management of an iatrogenic defect, which was caused during retrieval, by treating it as a canal extension during obturation. This obturation was done with glass ionomer cement based sealer for canal reinforcement. In the absence of other effective techniques, when the separated instrument is tightly lodged in the canal, Masserann technique could be useful for instrument retrieval in posterior teeth. However, its success depends on case selection and clinical skill. Since this technique leads to removal of considerable amount of dentin, use of bonding or adhesive obturation materials could be considered to reinforce and strengthen the root. DOI:10.21276/AOHDR.1897

Highlights

Masserann technique is one of the methods employed for orthograde retrieval of separated instruments, silver points and posts from the root canal
It is more effective in anterior teeth with a higher success rate. In posterior teeth this technique is risky and has limited application with lower success rate due to restricted accessibility, less root bulk and the presence of canal curvatures, when employed at or apical to mid root level. [1,2,3,4,5] Masserann technique can lead to iatrogenic errors such as excessive removal of dentin, root weakening, and root perforation. [5, 6] Masserann technique is effective in retrieval of separated instruments because of its locking and gripping mechanism though its application in selected posterior teeth is a difficult and a clinically challenging task. [1, 3]
Application of Masserann technique in a mandibular molar, in a mesial canal, is difficult due to posterior location of tooth with difficulty in obtaining and operating along a straight line access and limited visibility. This technique is more difficult in the mesial canal of mandibular second and third molars because of limited space to operate along a straight line access

Summary

Introduction

Masserann technique is one of the methods employed for orthograde retrieval of separated instruments, silver points and posts from the root canal. It is more effective in anterior teeth with a higher success rate. [1, 3] This case report illustrates successful application of Masserann technique to retrieve a separated instrument from the middle third of a mesial canal of a mandibular second molar and management of an iatrogenic defect by treating it as a canal extension during obturation which was done with a glass ionomer cement based sealer for canal reinforcement. The access opening was sealed and the patient was scheduled for post endodontic restoration (Fig 5)

Discussion

Conclusion