Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Case Report Volume 5 Issue 9

Periapical Healing Following Bypass of a Separated Instrument in a Mandibular Molar - A Case Report

Shahab Javanmardi1, Gurdeep Singh2* and Talal Al-Nahlawi3

1Specialist Endodontist at Mohammad Orthodontic Center, Muscat, Oman
2Senior Lecturer Adult Restorative Dentistry at Oman Dental College, Muscat, Oman
3Professor of Endodontics and Operative Dentistry at Syrian Private University, Syria

*Corresponding Author: Gurdeep Singh, Senior Lecturer Adult Restorative Dentistry at Oman Dental College, Muscat, Oman.

Received: August 16, 2021; Published: August 31, 2021


When a file fractures during root canal treatment, there are several treatment options available for the clinician. The definitive management should be based on a thorough knowledge of the success rates of each treatment option, balanced against potential risks of removal or file retention, with the availability of needed equipment and skills if the treating dentist. This paper describes a case of separated instrument which was treated by bypassing the separated fragment with one year follow up of the root canal treatment.

Keywords: Periapical Healing; Separated Instrument; Mandibular Molar


  1. L S. The dependence of the results of pulp therapy on certain factors: an analytic study based on radiographic and clinical follow-up examination”. Acta Odontologica Scandinavica 14 (1956): 1-175.
  2. Torabinejad M MN. “Endodontics Principles and Practice”. 4th St Louis: Elsevier Health Sciences (2009).
  3. Vaudt J., et al. “Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments”. International Endodontic Journal1 (2009): 22-33.
  4. Bonaccorso A., et al. “Shaping ability of four nickel-titanium rotary instruments in simulated S-shaped canals”. Journal of Endodontics6 (2009): 883-886.
  5. Lopes HP., et al. “Influence of rotational speed on the cyclic fatigue of rotary nickel-titanium endodontic instruments”. Journal of Endodontics7 (2009): 1013-1016.
  6. Cheung GS and Liu CS. “A retrospective study of endodontic treatment outcome between nickel-titanium rotary and stainless steel hand filing techniques”. Journal of Endodontics7 (2009): 938-943.
  7. Jafarzadeh H and Abbott PV. “Ledge formation: review of a great challenge in endodontics”. Journal of Endodontics10 (2007): 1155-1162.
  8. Ankrum MT., et al. “K3 Endo, ProTaper, and ProFile systems: breakage and distortion in severely curved roots of molars”. Journal of Endodontics4 (2004): 234-237.
  9. Wu J., et al. “Instrument separation analysis of multi-used ProTaper Universal rotary system during root canal therapy”. Journal of Endodontics6 (2011): 758-763.
  10. Madarati AA., et al. “Management of intracanal separated instruments”. Journal of Endodontics5 (2013): 569-581.
  11. Glickman GN. “AAE Consensus Conference on Diagnostic Terminology: background and perspectives”. Journal of Endodontics12 (2009): 1619-1620.
  12. Fu M., et al. “Removal of broken files from root canals by using ultrasonic techniques combined with dental microscope: a retrospective analysis of treatment outcome”. Journal of Endodontics5 (2011): 619-622.
  13. Gambarini G. “Cyclic fatigue of ProFile rotary instruments after prolonged clinical use”. International Endodontic Journal 5 (2001): 386-389.
  14. Al-Fouzan KS. “Incidence of rotary ProFile instrument fracture and the potential for bypassing in vivo”. International Endodontic Journal 12 (2003): 864-867.
  15. Bhuva B and Ikram O. “Complications in Endodontics”. Primary Dental Journal 4 (2020): 52-58.
  16. Parashos P and Messer HH. “Rotary NiTi instrument fracture and its consequences”. Journal of Endodontics 11 (2006): 1031-1043.
  17. Iqbal MK., et al. “A retrospective clinical study of incidence of root canal instrument separation in an endodontics graduate program: a PennEndo database study”. Journal of Endodontics 11 (2006): 1048-1052.
  18. Spili P., et al. “The impact of instrument fracture on outcome of endodontic treatment”. Journal of Endodontics12 (2005): 845-850.
  19. Wolcott S., et al. “Separation incidence of protaper rotary instruments: a large cohort clinical evaluation”. Journal of Endodontics 12 (2006): 1139-1141.
  20. Fishelberg G and Pawluk JW. “Nickel-titanium rotary-file canal preparation and intracanal file separation”. Compendium of Continuing Education in Dentistry1 (2004): 17-18.
  21. Saji S GP., et al. “Management of Instrument Separation: A Case Series”. Conservative Dentistry and Endodontic Journal2 (2019): 39-43.
  22. Low JF., et al. “Magnification in endodontics: A review of its application and acceptance among dental practitioners”. European Journal of Dentistry4 (2018): 610-616.
  23. Ng YL., et al. “A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health”. International Endodontic Journal7 (2011): 583-609.
  24. Ng YL., et al. “A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival”. International Endodontic Journal7 (2011): 610-625.
  25. Hülsmann M and Schinkel I. “Influence of several factors on the success or failure of removal of fractured instruments from the root canal”. Endodontics and Dental Traumatology6 (1999): 252-258.
  26. Shen Y., et al. “Factors associated with the removal of fractured NiTi instruments from root canal systems”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics5 (2004): 605-610.
  27. Nevares G., et al. “Success rates for removing or bypassing fractured instruments: a prospective clinical study”. Journal of Endodontics4 (2012): 442-444.


Citation: Gurdeep Singh., et al.. “Periapical Healing Following Bypass of a Separated Instrument in a Mandibular Molar - A Case Report”. Acta Scientific Dental Sciences 5.9 (2021): 169-174.


Copyright: © 2021 Gurdeep Singh., et al.. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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