Retrieving a Separated
Instrument
Doug Rakich DDS
Power Point Production:
Benjamin Schein DDS
Some Illustrations from Dr Nahmias
www.endoweb.com
Based on teachings from Drs.
Carr and Ruddle.
Mission one is to stage the
instrument.
With a modified
Gates Glidden Drill
Titanium CPR’s and high Mag
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I used a titanium CPR 6 and 7 under .8
mag on the Global with a Xenon light
source.
Mission one continued
Modified GG staging
Mission two is to shake it loose
by swirling the tip
of the US
counterclockwise
around the visible
fragment.
The real problem
► Once
the fragment is moving, the
real problem is that the coronal end wants
to crash into the mesial aspect of the mesial
root and does not want to "turn the corner"
toward a coronal path of exit.
The trick here is
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The trick here is to place the tip of the US
between the distal aspect of the fragment
and the furcal wall of the canal, flood the
canal with bleach and activate.
And be careful:
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Avoid cutting off the coronal end of the fragment, this can
cause you to lose the remainder around a curve.
I don't work the fragment itself so much as try to displace
it with the US.
The taper of the instrument results in the development of a
vertical force vector to the fragment, while the placement
of the US straightens the exit path.
I use the UC tip like an elevator for a root tip, working
vertically against the wall of the tooth
Sometimes I will put a slight bend on the US tip to
facilitate placement.
This straightens the path the instrument must take and the
aqueous environment amplifies the vibration while it cools
the tooth.
Sometimes it even works.