ABSTRACT
Background: Usually, iatrogenic problems can occur during the preparation of root canal therapy such as a broken file and perforation. The complex configuration of the root canal is one of the causes. Many strategies have been used to overcome these challenges. The common method is using a dental microscope and ultrasonic equipment to support the visualization and treatment procedures. During the broken file retrieval process, another iatrogenic error, such as a perforation of the root canal wall, could also occur. As a clinician, overcoming these problems is challenging. Case report: A 27-year-old female patient came with a chief complaint of pain in her lower left back tooth and secreted a yellowish salty fluid 1 month ago, Radiographic examination showed that there were 3 root canals and merged into 1. There were broken instruments in the apical third of the mesiobuccal canal with radiolucent lesions at the apical root. Case management: The initial steps were done by opening the access cavity, determining the working length, and the biomechanical preparation. An ultrasonic instrument was used to remove the broken file. During this process, the root canal wall perforation occurred and it was sealed with Mineral Trioxide Aggregate (MTA). The root canal obturation was done and direct composite resin restoration was chosen as a restoration. Conclusion: Sometimes, a broken file retrieval procedure can cause other iatrogenic problems. Good visualization and thorough management can support the success of the treatments.
