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Conservative management of intracanal separated endodontic instruments - treatment decisions and related factors

Tsvetelina Iliyanova Borisova-Papancheva, Silvia Stankova, Slavena Georgieva


INTRODUCTION: Intracanal separation of endodontic instruments is an adverse event that may not only hinder the endodontic treatment, but may also have an influence on the long-term prognosis and longevi­ty of the tooth.

MATERIALS AND METHODS: After studying a series of related articles and publications we have re­viewed and compared the different conservative treatment options for the management of intracanal frac­tured instruments.

RESULTS: Conservative management methods are leaving the fragment in situ and filling the coronal frag­ment of the root canal, bypassing the fractured instrument or completely removing it from the root canal. Each of these options has its advantages, disadvantages, special indications and every treatment decision is accompanied by possible risks and difficulties. Each case is different and the prognosis depends mainly on the location of the fragment, the root canal system (RCS) anatomy and morphology and, of course, on mak­ing the right treatment decision for managing the accident.

CONCLUSION: Separation of endodontic instruments in the root canal (RC) does not necessarily lead to endodontic failure and even in cases when the instrument cannot be removed choosing the adequate treat­ment procedure can strongly benefit the long-term prognosis of the tooth involved.


endodontic mishap, separated instrument, bypassing, removal

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About The Authors

Tsvetelina Iliyanova Borisova-Papancheva
Medical University of Varna

Department of Conservative Dentistry and Oral Pathology, Faculty of Dental Medicine

Silvia Stankova
Medical University of Varna

Department of Conservative Dentistry and Oral Pathology, Faculty of Dental Medicine

Slavena Georgieva
Dentist, Varna

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