{"id":619,"date":"2017-08-25T10:08:34","date_gmt":"2017-08-25T10:08:34","guid":{"rendered":"http:\/\/www.endostlaurent.ca\/2017\/08\/25\/ablation-dun-instrument-separe\/"},"modified":"2018-02-07T23:17:28","modified_gmt":"2018-02-07T23:17:28","slug":"ablation-dun-instrument-separe","status":"publish","type":"post","link":"https:\/\/endostlaurent.com\/en\/2017\/08\/25\/ablation-dun-instrument-separe\/","title":{"rendered":"SEPARATED INSTRUMENT RETRIEVAL"},"content":{"rendered":"<h3 style=\"text-align: center;\"><em>A case study by Dr. Chafic Safi, Centre Endodontique St-Laurent<\/em><\/h3>\n<p>&nbsp;<\/p>\n<p>A 51-year-old Caucasian female patient presented herself at our clinic with\u00a0the following primary complaint:<\/p>\n<blockquote><p>\u201cmy tooth hurts, I need to fix my root canal.\u201d<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<h2 class=\"title left\">Analysis<\/h2>\n<p>A clinical exam revealed a temporary restoration on her lower right canine (#43).<\/p>\n<p>Percussion testing was positive. Probing and mobility was within normal limits.<\/p>\n<p>A radiological exam revealed a previously accessed tooth.\u00a0There was a pronounced mid-root distal dilaceration and a separated rotary file reaching the apical third of the root.<\/p>\n<h3>Diagnosis<\/h3>\n<p>The diagnosis was a <strong>previously initiated therapy and symptomatic apical periodontitis.<\/strong><\/p>\n<p>&nbsp;<\/p>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-1 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 50%;\n\t\t\t}\n\t\t\t#gallery-1 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-1' class='gallery galleryid-619 gallery-columns-2 gallery-size-medium'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture1.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"104\" height=\"300\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture1-104x300.jpg\" class=\"attachment-medium size-medium\" alt=\"Radiographie pr\u00e9-op\u00e9ratoire \/ Pre-operative radiograph\" aria-describedby=\"gallery-1-493\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture1-104x300.jpg 104w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture1.jpg 217w\" sizes=\"(max-width: 104px) 100vw, 104px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-493'>\n\t\t\t\tFigure 1: Radiographie pr\u00e9-op\u00e9ratoire montrant la lime s\u00e9par\u00e9e \/ Pre-operative radiograph showing the separated instrument\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture2.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"198\" height=\"300\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture2-198x300.jpg\" class=\"attachment-medium size-medium\" alt=\"S\u00e9quence de l\u2019ablation \/ Sequential retrieval\" aria-describedby=\"gallery-1-494\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture2-198x300.jpg 198w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture2.jpg 404w\" sizes=\"(max-width: 198px) 100vw, 198px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-494'>\n\t\t\t\tFigure 2: Photo clinique montrant la s\u00e9quence de l\u2019ablation de la lime. Des pointes ultrasonores furent utilis\u00e9es pour faire vibrer la lime et la sortir du canal. \/ Clinical picture showing the sequential retrieval of the instrument. Ultrasonic tips were used to vibrate the instrument out of the canal\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n<h2 class=\"title left\">Treatment<\/h2>\n<p>The treatment options offered to the patient were:<\/p>\n<ol>\n<li>A non-surgical root canal treatment with bypass or retrieval of the instrument<\/li>\n<li>An extraction<\/li>\n<\/ol>\n<h3 id=\"tw-target-text\" class=\"tw-data-text tw-ta tw-text-medium\" dir=\"ltr\" data-placeholder=\"Translation\"><span lang=\"fr\">Treatment Selection<\/span><\/h3>\n<p>The patient opted for saving her tooth via a <a href=\"http:\/\/www.endostlaurent.ca\/traitement-de-canal\/\"><strong>root canal treatment<\/strong><\/a><strong>.<\/strong><\/p>\n<h3>Potential Complications<\/h3>\n<p>The following potential complications were discussed with\u00a0the patient:<\/p>\n<ol>\n<li>perforation<\/li>\n<li>separation of another instrument<\/li>\n<li>blockage\/not being able to retrieve or to bypass the separated instrument.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"title left\">More information<\/h2>\n<h3>Reasons for file separations<\/h3>\n<ul>\n<li>Cyclic fatigue: Over-use of the file<\/li>\n<li>Torsional stress: Locking and\u00a0over-twisting of the file<\/li>\n<\/ul>\n<h3>Tips on preventing file separations:<\/h3>\n<ol>\n<li>Pre-operative radiograph analysis: dilacerations, calcifications, \u2026<\/li>\n<li>Adequate access opening<\/li>\n<li>Proper glide path<\/li>\n<li>Don\u2019t force files<\/li>\n<li>Don\u2019t overuse files<\/li>\n<li>Smooth gentle motion<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"title left\">Additional Images<\/h2>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-2 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 33%;\n\t\t\t}\n\t\t\t#gallery-2 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-2' class='gallery galleryid-619 gallery-columns-3 gallery-size-medium'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture3.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"214\" height=\"300\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture3-214x300.jpg\" class=\"attachment-medium size-medium\" alt=\"S\u00e9quence de l\u2019ablation \/ Sequential retrieval\" aria-describedby=\"gallery-2-495\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture3-214x300.jpg 214w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture3.jpg 444w\" sizes=\"(max-width: 214px) 100vw, 214px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-495'>\n\t\t\t\tFigure 3: Photo clinique montrant la s\u00e9quence de l\u2019ablation de la lime. Des pointes ultrasonores furent utilis\u00e9es pour faire vibrer la lime et la sortir du canal. \/ Clinical picture showing the sequential retrieval of the instrument. Ultrasonic tips were used to vibrate the instrument out of the canal\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture4.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"144\" height=\"300\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture4-144x300.jpg\" class=\"attachment-medium size-medium\" alt=\"Instrument s\u00e9par\u00e9 \/ Separated instrument\" aria-describedby=\"gallery-2-496\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture4-144x300.jpg 144w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture4.jpg 294w\" sizes=\"(max-width: 144px) 100vw, 144px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-496'>\n\t\t\t\tFigure 4: La lime r\u00e9cup\u00e9r\u00e9e mesurant 12mm. La longueur de travail \u00e9tait de 25mm \/ The separated instrument retrieved measuring around 12mm. The working length was 25mm\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture5.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"195\" height=\"300\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture5-195x300.jpg\" class=\"attachment-medium size-medium\" alt=\"Radiographie finale \/ Final radiograph\" aria-describedby=\"gallery-2-497\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture5-195x300.jpg 195w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Picture5.jpg 397w\" sizes=\"(max-width: 195px) 100vw, 195px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-497'>\n\t\t\t\tFigure 5: Radiographie finale. Le syst\u00e8me endo-canalaire est scell\u00e9 avec du \u201cBioceramic sealer\u201d \/ Final radiograph. The root canal system was sealed using Bioceramic sealer\u00a0\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>A case study by Dr. Chafic Safi, Centre Endodontique St-Laurent &nbsp; A 51-year-old Caucasian female patient presented herself at our clinic with\u00a0the following primary complaint:&hellip;<\/p>\n","protected":false},"author":2,"featured_media":787,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[44],"tags":[31,32,33,34,35,36],"class_list":["post-619","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-etude-de-cas-case-study-en","tag-canal-radiculaire-en","tag-cas-dentaire-en","tag-clinique-dentaire-en","tag-endodontie-en","tag-etudes-de-cas-en","tag-traitement-de-canal-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts\/619"}],"collection":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/comments?post=619"}],"version-history":[{"count":0,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts\/619\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/media\/787"}],"wp:attachment":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/media?parent=619"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/categories?post=619"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/tags?post=619"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}