Rotary instrument fracture in the middle third of the mesial canal removed with ultrasound and magnification

Abstract

The patient was referred to a private practice for the removal of a fractured file from a right lower molar. Clinically, there was no evidence of painful symptoms. Radiographic examination revealed the presence of calcium hydroxide in the cervical region of the distal root and a fracture of the file in the middle third of the mesiolingual canal. The tooth was placed under absolute isolation, and bypass of the fractured file in the mesiolingual canal was initiated using C-Pilot files numbers 08-10 and 15. Subsequently, Univy Glide Path rotary files numbers #10.02, #10.03, #15.02, and #15.03 were cautiously introduced. Throughout the treatment, 1% sodium hypochlorite was used for chemical irrigation of the root canal system. The mesiolingual canal preparation was performed using a Univy New Individual Rotary File #20.04, followed by ultrasonic vibrations with the E18 tip (HELSE) at 50% power to remove the instrument. The mesiobuccal and distal canal preparations were performed using SRF Sequence - MK LIFE files #35/04 and #40/04, respectively, after electronic odontometry using an apex locator. The obturation of the root canal system was performed using the single cone technique associated with Bio-C Sealer cement. It is concluded that the microscope facilitates the visualization of the fragment and ultrasound facilitates the removal of the fractured instrument.