A case study by Dr. Chafic Safi, Centre Endodontique St-Laurent
A 65-year-old female patient presented to our clinic with the following chief complaint:
“My dentist sent me here to get an instrument out of my tooth.”
Analysis
A clinical examination revealed a restoration on tooth #17.
Percussion testing was positive. Probing and mobility were within normal limits.
A radiological examination revealed a previous root canal and a separated rotary file in the mesio-buccal canal.
Diagnosis
The diagnosis was a previously treated tooth and symptomatic apical periodontitis.
Treatment
The treatment options offered to the patient were:
- A non-surgical retreatment with bypass or retrieval of the instrument
- An extraction
Treatment Selection
The patient opted for saving her tooth via retreatment.
Potential Complications
The following potential complications were discussed with the patient:
- perforation
- separation of another instrument
- blockage/not being able to retrieve or to bypass the separated instrument.
The Treatment
Retreatment was completed with file retrieval and reinstrumentation of the canals in 3 dimensions using the XP-3D shaper and XP-3D Finisher files. Root canal obturation was achieved using Bioceramic Sealer and Bioceramic Gutta-Percha.
The patient was referred back to her dentist for her final restoration.
Additional Information
Reasons for file separation
- Cyclic fatigue: Over-use of the file
- Torsional stress: Locking and over-twisting of the file
XP files
- MaxWire special alloy
- Conservative and anatomical root canal preparations
- Less risks of iatrogenic errors such as file separation
Bioceramic Sealer:
- Biocompatible and antimicrobial
- Hermetic seal in 3 dimension
- Does not resorb nor shrink upon setting
- Hydroxyapatite formation