Case report demonstrates retrieval of a fractured file from the apical foramen in a maxillary central incisor, indicating effective endodontic surgery with a 3D printed guide.
This case report aimed to present an accurate and minimally invasive approach to retrieve a separated instrument beyond the apical foramen, using a 3‐dimensional (3D) printing guide and trephine bur. A 31‐year‐old female patient was referred for treatment of the left maxillary central incisor, complaining that a fractured file had been pushed out of the root canal by her previous dentist approximately 2 weeks prior. On clinical examination, tooth #9 was temporarily sealed and slightly tender on percussion. Periodontal probing was within normal limits. Radiographic and cone‐beam computed tomographic imaging revealed a periapical radiolucent lesion at tooth #9, with a separated instrument approximately 3 mm long extruded approximately 2 mm beyond the apical foramen and 4 mm deep in the bone. The tooth was diagnosed with symptomatic apical periodontitis. After root canal treatment, endodontic surgery was performed to retrieve the extraradicular separated instrument with the aid of a 3D printing guide and trephine bur. The root end was ultrasonically prepared and retrograde filled. The patient was asymptomatic when recalled 3 months and 2 years after the surgery, and the follow‐up periapical radiograph showed successful healing of the periapical lesion. This method enables a single‐step operation, completing the removal of the extraradicular separated instrument while performing osteotomy.
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Yang et al. (2025) studied this question.
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