Endodontic retreatment and retrieval of separated instrument using ultrasonic: A case report with clinical perspective

Rationale: Instrument separation is a serious issue that occurs in 2%–6% of instances following endodontic therapy. This condition is linked to a potential danger of contamination, which undermines the healing process. Handling a broken instrument is a challenging and time-consuming task that necessitates both ingenuity and expertise in clinical skills and knowledge. Patient Concerns: A female patient, 35 years old, presented with the primary concern of persistent pain associated with the lower left back tooth for the past 1 month, with a history of root canal therapy 6 years ago. Diagnosis: The diagnosis of symptomatic apical periodontitis secondary to previous failed endodontic treatment associated with instrument separation was established based on clinical and radiographic records. Interventions: Endodontic therapy was completed across two appointments following the successful gutta-percha removal and the effective retrieval of a fractured file from the mesiobuccal canal using ultrasonic and magnifying loupes. Outcomes: A 1.2-year follow-up has demonstrated that the retreatment was effective, and the patient remained asymptomatic afterwards. Lessons: Various systems and approaches have been created to retrieve the instruments, but none have consistently attained success. This case report details the use of a contemporary ultrasonic technology, performed under magnification, for the retrieval of a separated instrument during endodontic retreatment. This method has been shown to be a conservative approach.