Removal Of Separated Endodontic Files Inside Canal

- First of all: the file type controls the treatment plan.
- Then, We should know the area that the files has been separated in,

If Coronal Third then the file should be by-passed or removed by the manual H files that engage it from a side,
If middle third then the file should be removed or even by-passed and flared as manual filing,
If Apical third then the file should be removed ONLY, or even may be left in place ONLY if it is sealed with the apical foramen, otherwise should be removed.
It Beyond the apex or pushed after separation to pass beyond the apex then it must be removed through the canal or through the surgical apicectomy.

- Note: Manual K file should be removed by H files, Manual H files is easier to separate inside canals and is very difficult to be removed from the canals,
while the rotary file is not liable to fracture unless with inexperienced endodontists and removal of it is nearly impossible (especially it is one of the first files in the sequence ex: S1 and S2 of Protaper rotary files),
all the files mentioned above can be removed by ultrasonic scaller that hits the dentin debris next to the broken file causing vibration and elevation of the file toward the crown (but if it is very fitting inside the canal and broke due to excessive force applied into the canal then it will not be elevated by ultra-sonic scaler),
Finally, we can remove the separated file by using the Gates Glidden (GG), by applying GG size 2 or 3 next to the file, taking care not to perforate the root, causing a small hole to apply a small H file inside to remove or by-pass the separated file.

- In All Cases:
Recall the patient for check up every 1 week, 1 month, 3 months and 6 months,
Using the Sodium Hypocloride is very effective in by-passing and removal of the separated files,
Using the Glyde is very effective in by-passing the separated files,
Try to pre-curve the the tip end of the file before inserting inside the canal with gentle pressure and clock and  anti-clock wise directions to by-pass the file so that you can remove it or complete filing,
Try to start trying to deal with the separated file with manual files size 10 then 8 then 6, taking in consideration that liability of those files to separate increases as the size decreases.

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This Article has been Authored By :: World Of Dentistry :: TEAM
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:: World Of Dentistry :: TEAM