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Clinical decision-making after endodontic instrument fracture
M B McGuigan1, C Louca, H F Duncan
1Eastman CPD, UCL Eastman Dental Institute, 123 Grey's Inn Road, London, WC1X 8WD, UK.
British Dental Journal
|April 27, 2013
Summary
Fractured endodontic files do not necessarily worsen root canal treatment prognosis if apical disease is absent. Management decisions for fractured endodontic files should weigh risks against benefits, considering retention or bypass when appropriate.
Area of Science:
- Endodontics
- Dental Materials Science
Background:
- File fractures are a complication during root canal therapy.
- Management requires balancing removal risks against retention benefits.
Purpose of the Study:
- To review and analyze literature on the management of fractured endodontic files.
- To inform clinical decision-making regarding fractured file treatment options.
Main Methods:
- Systematic literature analysis of endodontic treatment outcomes.
- Evaluation of success rates and risks associated with fractured file removal versus retention.
Main Results:
- Fractured instruments do not reduce prognosis in cases without apical disease.
- File removal is not always necessary or feasible, especially if apical disease is absent.
- Apical disease significantly reduces prognosis, necessitating attempts at file removal or bypass.
Conclusions:
- Management of fractured files should be individualized based on the presence or absence of apical disease.
- Retention or bypass may be suitable alternatives to removal when no apical disease is present.
- Patient communication and record-keeping are crucial following instrument fracture.
