Treatment outcome of young molars obstructed by fractured endodontic instruments: two case reports

Thaís Christina Cunha,Luiz Renato Paranhos,Felipe De Souza Matos,Camilla Christian Gomes Moura

doi:10.33448/rsd-v9i10.8537

Thaís Christina Cunha, Luiz Renato Paranhos + Show 2 more

Open Access

https://doi.org/10.33448/rsd-v9i10.8537

Copy DOI

Abstract

Ultrasonic tips and anatomic finishing files have been used as strategies to improve the cleaning and disinfection of root canals, especially in complex anatomies. These instruments are also subjected to fractures, which can hinder the endodontic treatment and negatively affect the outcome. This article presents two cases of successful management of intracanal-fractured instruments with unfavourable prognosis, emphasizing on treatment protocols and outcomes. Two 14-year-old female patients underwent root canal treatment of teeth 37 (case 1) and 47 (case 2). During the final irrigation protocols, case 1 presented a fractured XP-Clean file within the mesiobuccal canal and within the distal canal in case 2, which also showed fractured E1-Irrisonic tips within the mesiobuccal and distal canals. Non-surgical management and bypassing retained instrument fragments were successful in both cases and they may be considered adequate approaches.

Highlights

This study aimed to present two cases of successful management of intracanal fractures of anatomic finishing files (XP-Clean) and ultrasonic inserts (E1-Irrisonic) with unfavourable prognosis, emphasizing on treatment protocols and outcomes
The use of ultrasound for removing broken rotary nickel-titanium files may result in some procedural errors such as transportation, perforation, and root fracture (Shahabinejad et al, 2013) or create a secondary fracture of separated file fragments (Arslan et al, 2020; Terauchi et al, 2013)
In the two cases reported, the attempt to remove the fragments with ultrasonic tips was partially unsuccessful, which led to their maintenance within the root canals due to the proximity to the mandibular canal, rendering surgical removal impossible

Summary

Introduction

New endodontic irrigation techniques using acoustic and hydrodynamic activation with sonic and ultrasonic devices (Bueno et al, 2019; Conde et al, 2017; Jiang et al, 2010) and anatomic finishing motor-driven files such as the XP-Endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and XP-Clean (MK Life, Porto Alegre, RS, Brazil) (Bao et al, 2017; Carvalho et al, 2019; Vaz-Garcia et al, 2018) were developed to improve the effectiveness of root canal cleaning and disinfection protocols (Nagendrababu et al, 2018; Susila & Minu, 2019). Este artículo presenta dos casos de manejo exitoso de instrumentos fracturados dentro del conducto radicular, con un pronóstico desfavorable, con énfasis en los protocolos y resultados del tratamiento.

Objectives

Results

Conclusion