Instrument Separation Outside the Root Canal: Handling Methods and Difficulties

In endodontics, fracturing of the instrument in the root canal can arise as an inevitable problem for the dentist, especially during the application of the metal-nickel-titanium devices to the root canal. What is more, the broken parts of the instruments may be beyond the point of the apex, which can produce a range of symptoms and cause additional physical and mental pain to the patients that must be relieved as fast as possible. A few cases are available, in which the separated endodontic instruments beyond the apex are addressed with surgical approaches, indicating that some cases can be resolved by surgical management. However, it is difficult to achieve the ideal results often due to bleeding, a lack of clinic experience, and an inability to accurately comprehend soft tissue activities. The best way, then, is to prevent the occurrence entirely if possible.