ABSTRACT
Background: Fracture of endodontic instruments is an unexpected event that hinders adequate root canal cleaning and shaping, and can negatively impact the outcome of endodontic treatment indirectly. The prevalence of fractured instruments is high on molar teeth, especially on poorly accessed cavities, and small diameter and acute curvature root canals. Nonsurgical removal of the fragment is one of the approaches to managing fractured instruments. This case report discussed the approach to the removal of a fractured file using an ultrasonic instrument at apical one-third in the disto-buccal canal of a second maxillary molar. Case report: A 55-year-old male patient complained of food impaction on his left upper back tooth. Clinical examination revealed pin-retained composite resin restoration with secondary caries on the mesial of tooth 27. After clinical and radiographical examination, tooth 27 was diagnosed with pulp necrosis with normal periapical. During the negotiation of the disto-buccal canal K-file #08 fractured at the apical third. Case management: The file fragment was removed using an ultrasonic endodontic tip under magnification with a dental operating microscope. Sodium hypochlorite irrigation was applied continuously. After the removal of the file fragment, nonsurgical root canal treatment was performed using a rotary file system and obturated using warm vertical compaction. Conclusion: Having adequate knowledge and armamentarium is important in managing endodontic mishaps such as separated instruments. This case report showed the successful removal of a broken file using an ultrasonic instrument.
