Endodontics on tooth 4.6 with a fractured file
Dr. Carlos Peón presents us with a case of success in which he uses the BlueShaper® instrumentation systems and the Z-Up and Z-Down obturation systems from Zarc
One of the characteristics in which a file must stand out is its resistance to cyclical fatigue, which is extremely important when it comes to preventing breakage inside the tooth and thus ruining a success story.
Today, Dr. Carlos Peón shows us a clinical case in which a patient has been referred to him from another clinic due to the lack of instrumentation and knowledge available to the specialist regarding this problem
A middle-aged patient visits the specialist for a root canal of the lower right first molar (4.6). Once the cameral opening is made and the canals are located, the specialist when starting to work faces the problem of a breakage of the file used in the mesiobuccal canal (MV).
The doctor, in the absence of resources to complete the case with satisfactory results, refers the patient to Dr. Carlos Peón’s office to resolve it.
Patient comes to the clinic with molar 4.6 previously started with symptomatic apical periodontitis. Once evaluated, treatment begins.
After anesthetizing, isolating and opening the fractured file, the fractured file is located (Fig 1)
Figure 1. Initial radiography. Fractured file in MV canal
Once the file is located, the doctor decides not to extract it due to:
– Reduced mouth opening
– MV duct joined in the middle third with ML
– Bypassing the file allows a greater conservation of the file than if it were extracted.
Using the K-Files 08 and 10 files it is possible to overcome the file. Once this step is done, the doctor begins mechanical instrumentation with the BlueShaper® instrumentation system. The process begins with the Z1 file and continues through the entire basic sequence until it reaches Z4, passing through all the canals of the molar.
Once the entire instrumentation process is complete, the doctor sonically activates the irrigants (sodium hypochlorite and EDTA) to make way for the obturation with the vertical compaction thermoplastic obturation system, Z-Up and Z-Down.
Figure 2. Obturation in 4.6
Figure 3. Final mesial radiograph
Figure 4. Final ortho radiograph