Retrieval of Separated Intracanal Endodontic Instruments: A Series of Four Case Reports

The separation of an endodontic instrument during a root canal procedure is one of the most common endodontic mishaps. Separation of endodontic instruments may block access to the apical portion of the root and hamper the disinfection process. It obstructs the appropriate debridement of the canal apical to the fragment, jeopardizing the treatment's outcome. However, due to the advancements in the methods and armamentarium, the effective retrieval of a separated instrument (SI) from the root canal has become possible. This paper includes a case series of management of separated instruments whereby SI was successfully removed in four cases. The instruments were separated intracanal at various levels in the middle and apical third of maxillary and mandibular molar teeth. The level of separation was located, staging performed, and SI was removed using an ultrasonic device under magnification. Removal of the SI was followed by obturation till the entire working length and subsequent post-endodontic restoration. Patient satisfaction with treatment outcomes in all cases was good. Case evaluation, good armamentarium, adequate knowledge along with good clinical skills and experience aid in the successful retrieval of separated instruments. Removal of the instrument without further damage to radicular dentin is important to maintain the integrity of the tooth.