FRACTURED FRAGMENT OF ENDODONTIC FILE IN THE APICAL THIRD: CASE REPORT WITH 13 YEARS OF FOLLOW-UP

Abstract

The primary objective of endodontic treatment is to eliminate or prevent infection within the root canal system by removing pulp tissue, bacteria, and their byproducts, while preserving the original canal anatomy and enabling effective three-dimensional sealing. This is particularly crucial in cases with significant infection. This case report details the management of an acute abscess in tooth 4.6, complicated by a separated instrument in the mesio-buccal root at the apical portion. The canal was instrumented using the K3 XF system, with files 25.10, 25.06, and 25.04 for the mesial canals, and 30.04 for the distal canals. Irrigation was performed with 5.25% sodium hypochlorite, 17% EDTA, and saline, which were activated by ultrasonics. Intracanal medication with calcium hydroxide was applied for 21 days, with two changes at 7 and 15 days. The root canal was then obturated using the continuous wave technique. This report emphasizes the protocol to follow when retrieval or bypassing a separated instrument is not feasible. The success of the treatment was attributed to thorough decontamination achieved by ultrasonic irrigation, the use of calcium hydroxide to reduce the microbial load, and the appropriate obturation technique. Finally, the definitive restoration of the tooth ensured its long-term preservation.