Management of fractured endodontic instruments

Management of separated endodontic instruments is a critical aspect of root canal treatment. Instrument separation can hinder canal disinfection and compromise the outcome. The approach depends on factors such as the location, type, and length of the fragment, as well as canal anatomy. Initial management involves assessing the clinical situation radiographically and under magnification. Ultrasonic tips, bypassing techniques, or retrieval systems like the Masserann kit may be employed for removal. If retrieval poses a high risk of root damage, the fragment may be left in situ and treatment continued, provided adequate disinfection has been achieved. Use of operating microscope, CBCT imaging, and thermomechanically stable NiTi files can enhance success. Patient communication and documentation are essential. Prevention through proper technique, regular inspection of instruments, and avoiding excessive force remains the best strategy.