Fractured instruments in endodontics: understanding incidence, mechanisms, and emerging retrieval techniques

Fractured instrument retrieval remains one of the most challenging aspects of endodontics, with reported incidence rates ranging from 0.3% to 12%. This complication is particularly common with nickel‒titanium (NiTi) rotary files used in curved canals. Instrument separation hinders effective canal disinfection, compromises the quality of obturation, and may necessitate additional interventions such as bypassing, retrieval, or surgical management. Conventional retrieval techniques often lead to dentin loss, compromising root structure. The use of dental operating microscopes and their integration with ultrasonic troughs, microtubes, and specialized retrieval kits, including loop devices, has significantly enhanced the predictability of retrieval procedures while minimizing the loss of tooth structure. However, the effectiveness of these methods remains highly dependent on operator skill. Numerous innovations are continually emerging to facilitate retrieval, with recent attention on magnetic fields. Studies on such emerging devices utilizing magnetic and electromagnetic attraction have introduced a promising new direction for further exploration. This review aims to provide a comprehensive, evidence-based perspective to guide clinical decision-making and keep practitioners updated about the latest advancements in minimally invasive retrieval techniques in endodontic practice.