Journal of South Asian Association of Pediatric Dentistry

Register      Login

VOLUME 3 , ISSUE 1 ( January-June, 2020 ) > List of Articles


Management of Endodontic Instrument Separation in Primary Teeth

Aditi Kapur, Krishan Gauba, Ashima Goyal

Keywords : Endodontic instrumentation, Instrument fracture, Management, Primary teeth

Citation Information : Kapur A, Gauba K, Goyal A. Management of Endodontic Instrument Separation in Primary Teeth. J South Asian Assoc Pediatr Dent 2020; 3 (1):34-38.

DOI: 10.5005/jp-journals-10077-3039

License: CC BY-NC 4.0

Published Online: 23-07-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Endodontic instrumentation is challenging in primary teeth due to narrow and curved roots that are under the influence of the physiological resorption process. Instrument separation in primary tooth root canal can have an adverse effect on erupting succedaneous teeth due to the persistence of infection and the risk of getting embedded into bone following root resorption. Case description: This paper comprised of a series of four cases with endodontic instrument separation at coronal third, middle third, apical third, and beyond apex in the root canal of primary teeth. All the cases were managed successfully using different strategies that include instrument retrieval, obturation and close periodic follow-ups, and the extraction of the involved tooth. Conclusion: Several factors determine the fate of the primary tooth with a separated instrument. Different management strategies can be tried considering the benefit vs risk in preserving the tooth.

  1. Waterhouse P, Whitworth J. Pediatric endodontics: endodontic treatment for the primary and young permanent dentition. In Cohen's pathways of the pulp. Kenneth Hargreaves, Stephen Cohen. 10th ed., St. Louis: Mosby; 2011. pp. 808–857.
  2. Bell RA, Dean JA. Managing the developing occlusion in dentistry for the child and adolescent. Dean McDonald 9th ed., Mosby; 2011. pp. 551–552.
  3. Morankar R, Goyal A. Clinical and radiographic characteristics of the primary teeth indicated for pulpectomy: a cross-sectional analysis. Int Healthc Res J 2018;2(9):223–228. DOI: 10.26440/ihrj.v2i9.182.
  4. Kohli M, Kim J. A retrospective clinical study of incidence of root canal instruments separation in an endodontic graduate program. J Endod 2005;31:223.
  5. Pettiette MT, Conner D. Procedural errors with the use of nickel-titanium rotary instruments in undergraduate endodontics. J Endod 2002;28:259.
  6. Mothanna. A. Comparative study of root-canal shaping with stainless steel and rotary NiTi files performed by preclinical dental students. Technol Health Care 2015;23(3):257–265. DOI: 10.3233/THC-150895.
  7. Parashos P, Gordon I, Messer H. Factors influencing defects of rotary nickel titanium endodontic instruments after clinical use. J Endod 2004;30(10):722–725. DOI: 10.1097/01.don.0000129963.42882.c9.
  8. Sonntag D, Delschen S, Stachniss V. Root canal shaping with manual and rotary Ni-Ti files performed by students. Int Endod J 2003;36(11):715–723. DOI: 10.1046/j.1365-2591.2003.00703.x.
  9. Morankar R, Goyal A, Gauba K, et al. Manual versus rotary instrumentation for primary molar pulpectomies - A 24 months randomized clinical trial. Pediat Dent J 2018;28(2):96–102. DOI: 10.1016/j.pdj.2018.02.002.
  10. Patel J, Morawala A, Talathi R, et al. Retrieval of a broken instrument from root canal in primary anterior teeth. Univ Res J Dent 2015;5(3):203–206. DOI: 10.4103/2249-9725.162799.
  11. Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. J Endod 2005;31(12):845–850. DOI: 10.1097/01.don.0000164127.62864.7c.
  12. Anusavice KJ. Mechanical properties of dental materials. In Phillips’ Science of Dental Materials. 11th ed., Philadelphia: Saunders; 2003.
  13. Cheung GSP, Peng B, Bian Z, et al. Defects in ProTaper S1 instruments after clinical use: fractographic examination. Int Endod J 2005;38(11):802–809. DOI: 10.1111/j.1365-2591.2005.01020.x.
  14. Peng B, Shen Y, Cheung GSP, et al. Defects in ProTaper S1 instruments after clinical use: longitudinal examination. Int Endod J 2005;38(8):550–557. DOI: 10.1111/j.1365-2591.2005.00991.x.
  15. Parashos P, Messer H. Rotary NiTi instrument fracture and its consequences. J Endod 2006;32(11):1031–1043. DOI: 10.1016/j.joen.2006.06.008.
  16. Cheung GS. Instrument fracture: mechanisms, removal of fragments, and clinical outcomes. Endod Topics 2009;16(1):1–26. DOI: 10.1111/j.1601-1546.2009.00239.x.
  17. Lambrianidis T. Therapeutic options for the management of fractured instruments. In: Lambrianidis T. Management of Fractured Endodontic Instruments. 1st ed., Springer, Cham 2018. 75–195.
  18. Shenoy A, Mandava P, Bolla N, et al. A novel technique for removal of broken instrument from root canal in mandibular second molar. Indian J Dent Res 2014;25(1):107–110. DOI: 10.4103/0970-9290.131157.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.