Alpha Omegan. ;83(4) Endodontic mishaps: etiology, prevention, and management. Torabinejad M(1). Author information: (1)School of Dentistry. Anatomic variations can significantly contribute to the incidence of endodontic mishaps. Perforations and separated instruments form the bulk of such mishaps. Download Citation on ResearchGate | Endodontic mishaps: etiology, prevention, and management | Root canal therapy consists of a cascade of.

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Hulsmann M, Schinkel I. The sealing ability of mineral trioxide aggregate as a retrograde root end filling material.

Ideally, radicular access should be performed in a way that the canal is pre-enlarged and shaped to the same diameter as that if there was no broken instrument obstructing the canal.

Special attention should be directed towards flaring the axial wall that approximates the canal holding the broken instrument in efforts to subsequently improve the micro-sonic techniques below the orifice. The canals were negotiated and hemostasis was achieved using calcium hydroxide.

Every clinician who has practiced endodontics has experienced the dilemma of broken or separated instruments. The radix entomolaris and paramolaris: In cases presenting with anatomical variations, such as RE, an integrated endodontic protocol should be followed.

It is hypothesized that the presence of RE adds to the stability of molars by providing an increased surface area of attachment to the alveolus. Investigation of mineral trioxide aggregate for root-end filling in dogs.

Nonsurgical management of endodontic mishaps in a case of radix entomolaris

Carlsen O, Alexandersen V. Mandibular first molar, with iatrogenic furcation endpdontic on the lingual aspect. Mineral trioxide aggregate MTA is a promising material that has been successfully used to repair perforations. On examination of the endodontic cavity, an irregular perforation defect was evident on the lingual aspect at the level of pulpal floor, which was accompanied by bleeding [ Figure 1 ].


Endodontic mishaps: etiology, prevention, and management.

This supernumerary root is located distolingually in mandibular molars, mainly the first molars. It should maintain a hermetic seal; it should be insoluble in tissue fluids, dimensionally stable, nonresorbable and also must exhibit biocompatibility, if not bioactivity. This article presents a clinical case report dealing with the utilization of MTA in successfully repairing furcal perforation along with the use of ultrasonic tips to retrieve separated instrument in a case of RE in mandibular first molar.

Support Center Support Center. Histologic assessment of MTA as root end filling in monkeys. An ultrasonic generator should provide a broad range of power, precise adjustment within the lower settings and electrical feedback to regulate amplitude and safe tip movement.

Importantly, the potential for safely removing a broken instrument is limited by root morphology, including the circumferential dimensions and thickness of dentin and depth of external concavity.

Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. Middle and apical thirds were prepared, and this was followed by apical gauging using hand instruments — nickel-titanium NiTiFlex files[ 22 ] — during which the separation of size 30 file occurred in the extra root RE.

Study of the number of roots and canals in Senegalese first permanent mandibular molars. On clinical examination, there was no evidence of attachment loss.

Radiograph showing inability to bypass the separated instrument. GG endodohtic 1 to 4 are most commonly used in multi-rooted teeth to remove fractured instruments.

A histologic evaluation of periodontal tissues adjacent to root perforations filled with cavit. Further, it may also facilitate the regeneration of the periodontal ligament. Journal List J Conserv Dent v.

Cinical applications of mineral trioxide aggregate. To facilitate excellent visibility of an intra-radicular obstruction, the canal should be vigorously flushed and thoroughly dried before beginning ultrasonic procedures.

After unsuccessful attempts to bypass the file, trephining was done by with using K-files ISO size 6, 8, 10, 15 nishaps Cellular response to mineral trioxide aggregate. This clinical case demonstrates the use of MTA as a repair material for furcal perforation due to an iatrogenic error in radix entomolaris in the mandibular first molar.


At times, when kishaps ultrasonic instrument is introduced into a pre-enlarged canal, its activated tip does not have sufficient space lateral to the broken file segment to initiate trephining procedures. A year-old male who presented with accidental furcal perforation, which endodonttic occurred during the access preparation for root canal treatment of tooth no.

Furcal perforation was confirmed by periapical radiograph of tooth no. Tsesis I, Fuss Z. It is known that the mandibular first molar can display several anatomical variations. The choice of MTA was made as there was no communication with the gingival sulcus. National Center endodontjc Biotechnology InformationU. Both clinical and radiographic follow-up showed a stable condition without any probing defect, ongoing root resorption, or furcal pathosis.

Physical and chemical properties of a new root-end filling material.

Endodontic mishaps: etiology, prevention, and management.

Author information Article notes Copyright and License information Disclaimer. Hemostasis in endodontic microsurgery. Food and Drug Administration in A 2 year follow up. Open in a separate window.

It also describes the application of ultrasonic technique in the retrieval of separated instrument from the same. Clinical approach in endodontics. Regardless of the etiology, the perforation should be repaired as soon as possible to discourage further loss of attachment and to prevent periodontal pocket formation. Retreatment of nonhealing endodontic therapy and management of mishaps.