Estrategia de retiro de instrumentos fracturados en la práctica endodóntica: Revisión de la literatura
DOI:
https://doi.org/10.31984/oactiva.v7i2.750Keywords:
separate instruments, files, endodontic, removal strategies, root canalAbstract
The separation of instruments during endodontic treatment hinders the chemomechanical cleaning procedures, the correct shaping and hermetic obturation of the root canal system. Consequently, technological advances have made it possible to have separate instrument removal systems, including ultrasonic devices and other special extraction systems, in addition to the dental surgical microscope that minimize procedural times and excessive wear of root canal dentin.
The objective of this Narrative Review was to analyze and compare strategies regarding the type of clinical resolution in instrument separation, providing clinicians with clear and definitive evidence and information regarding the most appropriate strategy so that the results are predictable during the procedure. Information was searched in databases: PubMed/Medline, Scielo, Scopus and Google Scholar; 30 articles were selected after an evaluation according to inclusion and exclusion criteria, covering in vitro experimental studies, clinical trials and case reports. The results showed a variation in the removal success rate between 47% and 100% in relation to the techniques used, anatomical factors of the root canal, the type and location of the separated fragment inside the canal. It was concluded that the incorporation of tissue-conserving extraction systems, shorter resolution times and the use of magnification were the most important variables; however, these systems are associated with complications and their use should be evaluated.
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Nevares G, Sanchez R, Zuolo ML, da Silveira CE. Success Rates for Removing or Bypassing Fractured Instruments: A Prospective Clinical Study. Journal of Endodontics. 2012; 38(4): p. 442-444.
Machado R, de Souza C, Colombelli M, Picolli A, Simi J, Cosme L, et al. Incidence of ProTaper Universal System Instrument Fractures - A Retrospective Clinical Study. Eur Endod J. 2018 Julio; 3(2): p. 77-81.
Gencoglu N, Helvacioglu D. Comparison of the Different Techniques to Remove Fractured Endodontic Instruments from Root Canal Systems. Eur. J Dent. 2009; 3: p. 90-95.
Adl A, Shahravan , Farshad M, Honar S. Success Rate and Time for Bypassing the Fractured Segments. Iranian Endodontic Journal. 2017 06 Junio; 12(3): p. 349-353.
Cvikl B, Klimscha , Holly , Zeitlinger , Gruber , Moritz. Removal of fractured endodontic instruments using an Nd:YAG laser. Quintessence Int. 2014; 45(7): p. 569-575.
Herrera C, Casasola E. Una técnica conservadora para la eliminación de instrumentos separados. Canal Abierto. 2019; 40: p. 16-19.
Madarati A, Watts DC, Qualtrough A. Factors contributing to the separation of endodontic fi les. Br Dent J. 2008; 204(5): p. 241-245.
Ward J, Parashos P, Messer H. Evaluation of an Ultrasonic Technique to Remove Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals: An Experimental Study. J Endod. 2003 Noviembre; 29(11): p. 756-763.
Terauchi Y, Christopher S, Bakland L, Bogen G. Factors Affecting the Removal Time of Separated Instruments. J Endod. 2021; 47: p. 1245–1252.
Wolhgemuth P, Cuocolo D, Vandrangi P, Sigurdsson A. Effectiveness of the GentleWave System in Removing Separated Instruments. J Endod. 2015;: p. 1-4.
Meidyawati , Suprastiwi , Dwi Setiati H. Broken File Retrieval in the Lower Right First Molar Using an Ultrasonic Instrument and Endodontic Micro Forceps. 2019 Octubre;: p. 1-4.
Jimenez JL, Calderon AN, Tello B, Hernandez HM. Instrumentos rotatorios: su uso, separación y efecto en complicaciones endodónticas postoperatorias. Revista Odontologica Mexicana. 2014 Enero-Marzo; 18(1): p. 27-31.
Velez R, Guerrero M, Cordero P. Remocion de un instrumento fracturado durante la terapia endodontica: Reporte de un caso. ODONTOLOGIA activa UCACUE. 2016; 1(1): p. 24-28.
Kaddoura R, Madarati A. 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 Octubre; 15(5): p. 431–436.
Alomairy K. Evaluating Two Techniques on Removal of Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals: An In Vitro Study. J Endodontic. 2009 Abril; 35(4): p. 559-562.
Fu M, Zhang Z, Hou B. Removal of Broken Files from Root Canals by Using Ultrasonic Techniques Combined with Dental Microscope: A Retrospective Analysis of Treatment Outcome. JOE. 2011; 37(5).
Shen Y, Peng B, Shun pan G. Factors associated with the removal of fractured NiTi instruments from root canal systems. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Noviembre; 98(5): p. 605-610.
Shahabinejad H, Ghassemi A, Pishbin , Shahravan. Success of Ultrasonic Technique in Removing Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals and Its Effect on the Required Force for Root Fracture. JOE. 2013 Junio; 39(6): p. 824-828.
Ward J, Parashos P, Messer H. Evaluation of an Ultrasonic Technique to Remove Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals: Clinical Cases. J Endod. 2003 Noviembre; 29(11): p. 764-767.
Alrahabi M, Ghabbani H. Removal of a separated endodontic instrument by using the modified hollow tube–based extractor system: A case report. SAGE Open Medical Case Reports. 2020; 8: p. 1-4.
Nagai O, Tani N, Kayaba Y, Kodama S, Osada T. Ultrasonic removal of broken instruments in root canals. Int Endod J. 1986; 19: p. 298-304.
Souter N, Messer H. Complications Associated with Fractured File Removal Using an Ultrasonic Technique. Endod J. 2005 Junio; 31(6): p. 450-452.
Suter B, Lussi A, Sequeira P. Probability of removing fractured instruments from root canals. Int Endod J. 2005 Febrero; 38(2).
Cujé J, Bargholz C, Hulsmann M. The outcome of retained instrument removal in a specialist practice. Int Endod J. 2010; 43: p. 545-554.
Pruthi P, Nawal R, Talwar S, Verma M. Comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit for the removal of separated endodontic instruments. Restor Dent Endod. 2020 Mayo; 45(2): p. 1-7.
Yang Q, Shen Y, Huan , Zhou X, Gao Y. Evaluation of Two Trephine Techniques for Removal of Fractured Rotary Nickel-titanium Instruments from Root Canals. J Endod. 2016;: p. 1-5.
Yue X, Shen J, Zhang H. Estudio experimental in vitro que compara los efectos de tres tipos de dispositivos de microcánula para extraer y separar dispositivos. Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Abril; 38(2): p. 160–165.
Frota L, Aguiar B, Aragao M. Removal of Separated Endodontic K-File with the Aid of Hipodermic Needle and Cyanoacrylate. 2016.
Cvikl B, Klimscha J, Holly M, Zeitlinger M, Gruber R, Moritz A. Removal of fractured endodontic instruments using an Nd: YAG Laser. Quintessence Int. 2014; 45(7): p. 569-575.
Shenoy A, Mandava P, Bolla N. A novel technique for removal of broken instrument from root canal in mandibular second molar. Indian J. 2014; 25(1): p. 107-110.
Satheesh S, Jain S, Bhuyan A, Devi L. Surgical Management of a Separated Endodontic Instrument using Second Generation Platelet Concentrate and Hydroxyapatite. 2017 Junio; 11(6): p. ZD01–ZD03.
Harada T, Harada K, Nozoe A, Tanaka S, Kogo M. A novel surgical approach for the successful removal of over-extruded separated endodontic instruments. J Endod. 2021 Agosto.
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