2022-08-28 22:24:10
#case_endo
Custom extractor fully explained
Referred case from a colleague for management of a separated file in the MB canal of lower 1st molar .
At first I attempted bypass as the fragment was 16 mm away from the reference point ( apical part ) , separated file was new so most probably it was separated due to torsional fatigue or faulty file , so high engagement was suspected.
I decided to bypass using rotary files to ramp up the process but this was a big mistake to attempt that without full manual bypassing first , the first file was Hyflex EDM 10/.05 was placed in the space ( catch area ) to immediately separate , So I stopped that to attempt retrieval.
Circumferential prep around the file was created using Ultrasonic VAT-3 device silver tip .
A wired loop was tightened around the file 2 times but it was torn twice due to the strong binding of the file to the canal wall .
Another retrieval strategy was attempted using multiple custom tube like intramuscular injection tips with different lengths & diameters , flowable composite tips , a bend was made on the hub & a hole was made at the top of the tip & the bottom also for more engagement ( x-rays shows multiple trials with the custom tubes )
I kept trying till one was fitted ( x-ray confirmed )
I noticed that secondary fracture is about to occur ( x-ray detected ) so I stopped using ultrasonic & used the trephination bur to create more space to accommodate both the tube , spreader & SF to engage the fragment.
Both files 10/.05 & 20/.04 was retrieved
Bassi Logic for Shaping
Well-Root ST bc sealer for obturation to reveal large lateral (furcal ) canal related to the furcal radi olucency in a buccal direction .
Details under each photo
Thanks
#MMENDOMANIA
https://t.me/TDoDL2
275 viewsفضل الصبري, 19:24
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