Management of Intracanal Separated Instrument Using Bypassing and Braiding Techniques: Case Reports

The separation of an endodontic instrument during a root canal procedure is a complication that can significantly hinder successful treatment. Separated instruments blocked access to the apical portion of the root, impeding adequate apical canal debridement and potentially compromising disinfection efficacy, thereby jeopardizing the long-term success of the endodontic therapy. Recent advancements in endodontic technology and methodology have facilitated the management of separated instruments (SIs), potentially enhancing treatment prognosis This article presents a case series of the management of SI using bypassing and braiding techniques. Separated instruments were lodged at various levels in the middle and apical third of the maxillary and mandibular incisor and canine teeth. Today, the majority of broken instruments can potentially be removed safely and effectively. However, instrument removal techniques lead to significant loss of tooth substances, which increases the risk of tooth fracture. The choice of the most appropriate technique for removing the fractured fragment depends on several parameters. The two techniques used in these clinical cases are conservative, simple and less invasive for instrument removal.