How to Bypass A Broken File: Friday Questions

 

How to Bypass A Broken File: Friday Questions

We’ve all clinicians and welcome to another flight, a question session. This Friday’s question comes to us from a viewer who asks: how can i bypass broken instruments in the root canal? So, let’s take a look at it to avoid having to bypass broken instruments in the root canal is to avoid breaking instruments in the root canal.

However, it’s obvious that instruments do break in the root canal, whether stainless steel or nighttime instruments are prone to separation. Sometimes, of course, luckily, the incidence of separated instruments are very low in root canal therapy, and they’re, not necessarily considered malpractice.

However, they are difficult situations to deal with because often times they act as obstacles in along the path of completing the complete cleaning and shaping of the root canal. So how can we bypass them in order to proceed to complete the root canal therapy effectively and also be able to get good results? Well, the best way to do so is the first of all separate the kinds of instrument breakage that we can have into two instruments that separate admit, root or close to the coronal area, to the orifice of the root canal and those instruments that break At the mid-root and below or towards the apex of the root canal, because they’re fairly they’re, basically different situations anytime, where you have direct straight-line access to a separated instrument, you have a chance at removing that instrument.

However, when that a straight path becomes curved, which means if an instrument is separated beyond a curvature, pass that straight path, then the removal is very, very difficult. You can remove separated instruments that have broken before this curvature, which usually is about the mid root level or so on by creating a passage or a straight line, access to create a platform for these instruments.

What I mean we platform well, you would have to use an instrument such as a case Clayton, 3 or 4, and you basically chop off of this instrument, and it becomes a flat cutting instrument that you would take all the way down to the separated instrument. Once you have a flat base or a platform around the separated instrument, then you can use a very thin ultrasonic tip and activate the broken instrument right at the point where it has been separated.

Of course, in order to do any of this, you do require high magnification illumination in the form of the microscope, often times people say well. How can I remove a separated instrument without a microscope, and the answer is well sorry, you can’t do it there are many things in life where we want to have our cake and eat it too. This is one of those things, but unfortunately we can’t have our cake and eat it too.

So you do need magnification illumination in order to remove separated instruments and that’s just the way it is. You know many manufacturers are trying to sell us various devices to try to remove a separate instrument without magnification. But I can tell you that unless the instrument would have probably come out on its own, it’s very difficult to not be able to visualize the instrument.

And yet be still able to remove it, where, when instruments break beyond the half of the route, the curvature of the route where you can have straight-line access, and you need to bypass them, then there are some tricks that you could apply in order to try To bypass them, of course, there is some luck involved here, because first, the type of instrument that you use or the instrument that is separated, will have a lot to do with whether you were able to bypass it or not. Files that have lands create a lot.

They basically occupy a lot more space in the root canal and therefore there’s less space for you to bypass. When you have a landed file that has been broken into the canal, then a file that is non landed, non-landed files. I have a lot of space around them so that you can bypass with an instrument and you what you need is a size, 6 and 8 stiff file and hand files. Obviously that you would then

 

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