Instrument fracture: mechanisms, removal of fragments, and c

[tirath]

Instrument fracture can be an unpleasant mishap during non-surgical root canal treatment. While most stainless-steel instruments appear to fail by excessive amounts of torque, the combined action of torsional stress and cyclic loading (i.e. fatigue, as a result of rotational bending, or repeated torsion) is responsible for the breakage of NiTi rotary files in use. Factors affecting the incidence and mode of failures include the instrumentation technique, use of torque-controlled motor, the dimension and surface condition of the instrument, rotation rate, radius (and, to a certain extent, angle) of canal curvature, and the presence of a straight-line access and a ‘glide path’ to the apical portion of the canal. If breakage should occur clinically, the patient should be informed of the incident and consideration should be given as to whether or not to remove the fragment. Managed properly, the presence of a broken fragment per se may not adversely affect the outcome of root canal treatment. This review examines the various aspects (including mechanisms, contributing factors, prognosis and management) of instrument fracture. Emphasis is placed on the separation of nickel–titanium rotary files and ways to prevent this in the clinical situatio

        

[sushantpatel_doc]

So basically how do we remove these seperated instruments from the canal? Some retrieving kits are also available…want to know more about them..

        

[tirath]

ROCK HILLl, South Carolina–KOMET USA offers practitioners “peace of mind” in the United States with the introduction of a broken endodontic file retrieval kit.

Developed in conjunction with Dr. Dominique Martin of Paris, France, KOMET’s Endo Rescue Kit (Kit 4601) is designed for the quick and simple retrieval of a fractured rotary nickel-titanium instrument within the canal.

The kit comes with an H269GK.315.016 endodontic tungsten carbide bur to enlarge the pulp cavity. This improves a practitioner’s vision into the canal.

A center drill (G180A.204.110/G180.204.090) excavates the last few millimeters of the canal, providing the practitioner enough access to the broken instrument.

The RKP.204.090 drill exposes the instrument’s surface. An extremely-fine trepan bur (RKT.204.090) is placed onto the fragment, seizing and holding it in place using residual dentin. The broken file is then removed from the canal in a counter-clockwise motion.

The kit also comes with manual screw (150.155.000) for those practitioners who would rather not use a handpiece.

        

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