Comparing Techniques for Removal of Separated Endodontic Instruments: Systematic Review and Meta-analysis

Purpose: The goal of this study is to look into several approaches to approaching damaged instruments in the root canal, as well as to show possible outcomes in terms of dentin thickness, fracture resistance, technique success, and clinical time. Methodology: PubMed, Cochrane, Lilacs, Web of Science, Scopus, grey literature, and manual searches were used to conduct the bibliographic research. The titles and abstracts of 506 papers were examined using the inclusion and exclusion criteria. Sixty items were chosen and read in their entirety. This systematic review includes fourteen papers. Results: The ultrasonic approach was the most extensively researched and yielded positive results in general. The more apically positioned the tool is, the more difficult it is to remove it, the more dentin is removed, and the poorer the tooth's fracture resistance. When removal is not possible, the bypass technique (bypassing) can be employed, and the GentleWave System approach can be used on weakened teeth or with little dental fragments. Conclusion: The data from laboratory investigations showing the curvature and root third in which instrument fractures originate is related to fracture resistance and success is presented in this comprehensive review