Journal of Operative Dentistry & Endodontics

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VOLUME 7 , ISSUE 1 ( January-June, 2022 ) > List of Articles

CASE REPORT

Management of Separated Instrument at Apical Third of a Mandibular Molar by Intentional Replantation: A Case Report

Krishnamoorthy Kunguma Supraja, Raja Sethupathi, Davidson Diana, Manali Ramakrishnan Srinivasan

Keywords : Instrument separation, Intentional replantation, Rotary, Nickel-titanium, Root canal treatment

Citation Information : Supraja KK, Sethupathi R, Diana D, Srinivasan MR. Management of Separated Instrument at Apical Third of a Mandibular Molar by Intentional Replantation: A Case Report. J Oper Dent Endod 2022; 7 (1):11-15.

DOI: 10.5005/jp-journals-10047-0121

License: CC BY-NC 4.0

Published Online: 21-08-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Endodontic mishaps during root canal treatment are the most commonly encountered errors, affecting the treatment quality and possibly posing a risk to the patient's health. Separation of an endodontic instrument during the root canal therapy is one such frequently encountered mishap. Clinicians should assess the risk over benefit, while attempting non-surgical instrument retrieval at apical third. Exceptionally, endodontic periradicular surgery is not always feasible due to anatomic limitations. In such circumstances intentional replantation might be an alternative. This case report presents the successful management of an endodontic mishap through intentional replantation.


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  1. Madarati AA, Hunter MJ, Dummer PM. Management of intracanal separated instruments. J Endod 2013;39(5):569–581. DOI: 10.1016/j.joen.2012.12.033.
  2. Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. J Endod 2005;31(12):845–850. DOI: 10.1097/01.don.0000164127.62864.7c.
  3. Knowles KI, Hammond NB, Biggs SG, et al. Incidence of instrument separation using LightSpeed rotary instruments. J Endod 2006;32(1):14–16. DOI: 10.1016/j.joen.2005.10.008.
  4. Wolcott S, Wolcott J, Ishley D, et al. Separation incidence of protaper rotary instruments: a large cohort clinical evaluation. J Endod. 2006;32(12):1139–1141. DOI: 10.1016/j.joen.2006.05.015.
  5. Kaddoura RH, Madarati AA. Management of an over-extruded fragment in a C-shaped root canal configuration: A case report and literature review. J Taibah Univ Med Sci 2020;15(5):431–436. DOI: 10.1016/j.jtumed.2020.07.001.
  6. Hülsmann M. Methods for removing metal obstructions from the root canal. Endod Dent Traumatol 1993;9(6):223–227. DOI: 10.1111/j.1600-9657.1993.tb00278.x.
  7. Terauchi Y. Separated file removal. Dent Today 2012;31:110–113.
  8. Panitvisai P, Parunnit P, Sathorn C, Messer HH. Impact of a retained instrument on treatment outcome: a systematic review and meta-analysis. J Endod 2010;36(5):775–780. DOI: 10.1016/j.joen.2009.12.029.
  9. Becker BD. Intentional replantation techniques: A critical review. J Endod 2018;44(1):14–21. DOI: 10.1016/j.joen.2017.08.002. Epub 2017 Oct 21.
  10. Bender IB, Rossman LE. Intentional replantation of endodontically treated teeth. Oral Surg Oral Med Oral Pathol 1993;76(5):623–630. DOI: 10.1016/0030-4220(93)90073-d.
  11. Harada T, Harada K, Nozoe A, et al. A novel surgical approach for the successful removal of overextruded separated endodontic instruments. J Endod 2021;47(12):1942–1946. DOI: 10.1016/j.joen.2021.08.012. Epub 2021 Sep 3.
  12. Vivan RR, Costa VASM, Conti LC, et al. Effect of nickel-titanium alloys on root canal preparation and on mechanical properties of rotary instruments. Braz Oral Res 2022;36:e085. DOI: 10.1590/1807-3107bor-2022.vol36.0085.
  13. McGuigan MB, Louca C, Duncan HF. Endodontic instrument fracture: Causes and prevention. Br Dent J 2013;214(7):341–348. DOI: 10.1038/sj.bdj.2013.324.
  14. Peer M. Intentional replantation - a ‘last resort’ treatment or a conventional treatment procedure? Nine case reports. Dent Traumatol 2004;20(1):48–55. DOI: 10.1046/j.1600-4469.2003.00218.x.
  15. Kratchman S. Intentional replantation. Dent Clin North Am 1997;41(3):603-617. PMID: 9248694.
  16. Fouad AF, Abbott PV, Tsilingaridis G, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatol 2020;36:331–342.
  17. Kahler B, Hu JY, Marriot-Smith CS, et al. Splinting of teeth following trauma: A review and a newsplinting recommendation. Austr Dental J 2016;61(Suppl 1):59–73.
  18. Plotino G, Abella Sans F, Duggal MS, et al. European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation: European Society of Endodontology developed by. Int Endod J 2021;54(5):655–659. DOI: 10.1111/iej.13456. Epub 2021 Jan 26.
  19. Cho SY, Lee Y, Shin SJ, et al. Retention and healing outcomes after intentional replantation. J Endod 2016;42(6):909–915. DOI: 10.1016/j.joen.2016.03.006. Epub 2016 Apr 14.
  20. Grossman LI. Intentional replantation of teeth. J Am Dent Assoc 1966;72(5):1111–1118. DOI: 10.14219/jada.archive.1966.0125.
  21. Weine FS. The case against intentional replantation. J Am Dent Assoc 1980;100(5):664–668. DOI: 10.14219/jada.archive.1980.0227.
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