CLINICAL AID A New Approach for the Retrieval of Broken Instruments

The purpose of this article is to present a modified ultrasonic spreader and a new technique that are used for the retrieval of solid obstructions that can not be bypassed by conventional methods. The technique advocated and the instruments proposed are described. A clinical case is discussed to show the possibilities and limitations of both instrument and method. Several methods and techniques are advocated for the removal of solid objects, such as silver points, fragments of an instrument, or posts. Accessible solid obstructions may be withdrawn from the canal by a variety of instruments, including forceps, pliers, or a Castroveijos needle holder (1-3). Sometimes mechanical interventions should be undertaken and sophisticated tools such as the Masserann endodontic kit (4) and the Endo Extractor (5) are recommended. Endodontic textbooks (6) advocate bypassing the obstruction before trying to retrieve it from the canal. It could be done manually by the use of one or multiple Hedstrom files MATERIALS AND METHODS Instrumentation consists of a piezoelectric ultrasonic unit and an ultrasonic spreader (S04) by Satellec (France). The modifications suggested to the spreader concerns its taper and diameter. A separating disc (Speedy, Hollicer, France) is used to reduce the diameter at the tip to 0.20 to 0.25 mm at D1 and at D2 (16 mm from D1) to 0.5 to 0.6 ram. This will roughly make a taper 0.02 spreader. A small round bur (#2 of Maillefer, Ballaigues, Switzerland) is used to make a hole in the shank to allow irrigation 633 sectional diameter to obtain a predictable caliber (GG1 = 0.5 mm, GG2 = 70 mm) (12). A #10 file and 25 mm long shortened by (2 to 3 mm) will have a sharp edge at the working end and a suitable rigidity (13). This technique is applied whenever bypassing the obstruction is impossible. It could be divided into three steps. Step l: The clinician should create sufficient space coronal to the obstruction. This is accomplished by serial use of files and GG drills. Files ar