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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The presence of RE was evident on the working length radiograph [ Figure 4 ].

Nonsurgical management of endodontic mishaps in a case of radix entomolaris

GG sizes 1 to 4 are most commonly used in multi-rooted teeth to remove fractured instruments. Torabinejad M, Chivian N.

In cases presenting with anatomical variations, such as RE, an integrated endodontic protocol should be followed. Radiographic evidence of perforation defect extending into the furcation area. 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 has been cited by other articles in PMC. A year-old male who presented with accidental furcal perforation, which had occurred during the access preparation for root canal treatment of tooth no.

Endodontic mishaps: etiology, prevention, and management.

Cellular response to mineral trioxide aggregate. Influence of periapical tissues of indigenous oral bacterial and necrotic pulp tissues in monkeys.

Carlsen O, Alexandersen V. Micro-sonic techniques, as advocated for removal of separated instruments, do not generally generate heat to an extent that it harms the attachment apparatus. Mandibular first molar, with iatrogenic furcation perforation on the lingual aspect.

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. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. A review of literature.

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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. MTA was gently packed against the dentinal wall by using a damped cotton pellet [ Figure 3 ]. At times, when an 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.

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 endoodontic Figure 1 ]. Perforations and separated instruments form the bulk of such mishaps. The factors influencing broken instrument removal should be identified and taken into consideration while attempting such cases. Oregon Health Sciences University; The four defining characteristics of a perforation that always occur in combination are level, location, size and time.

Endodontic mishaps: etiology, prevention, and management.

A 2 year follow up. Cinical applications of mineral trioxide aggregate. After thorough cleaning and shaping, selection of Gutta-percha master cone was confirmed by using a radiograph [ Figure 7 ].

Furcal perforation was confirmed by periapical radiograph of tooth no. To facilitate excellent visibility of an intra-radicular obstruction, the canal should be vigorously flushed and thoroughly dried before beginning ultrasonic procedures.

Scand J Dent res. Scan J Dent Res. Both clinical and radiographic follow-up showed a stable condition without any probing defect, ongoing root resorption, or furcal pathosis. Refinements in endodontic cavity preparation and radicular inclinations should be given due considerations in teeth presenting anatomical variations such as radix entomolaris so as to prevent procedural accidents during various endodontic and restorative procedures.

The canals were debrided and disinfected using copious amounts of 2. Tsesis I, Fuss Z. 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 endodontiic extra root RE.


A number of techniques may be employed in flaring the canal coronal to an intracanal obstruction. An additional third root, first mentioned in the literature by Carabelli is called radix entomolaris RE. Articles from Journal of Conservative Dentistry: Furcal perforations are undesired complications of endodontic treatment, which result in the loss of integrity of the root and further destruction of the adjacent periodontal tissues.

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.

Nonsurgical management of endodontic mishaps in a case of radix entomolaris

Histologic assessment of MTA as root end filling in monkeys. Radix paramolaris in permanent mandibular molars: Marshall FJ, Papin J. Repair of the perforation defect using mineral trioxide aggregate barrier material. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reports have strongly suggested that the favorable biologic performance exhibited by MTA materials is due to the formation of hydroxyapatite when these materials are exposed to physiologic solutions. Food and Drug Administration in Further, it may also facilitate the regeneration of the periodontal ligament. Fuss Z, Trope M.