JVD 2015 #4 - Managing Endodontic Instrument Separation

Question 1

“Managing endodontic instrument separation” by McCoy,

what are the two most common causes of instrument separation?

Answer 1

instrument fatigue from overuse, applying excessive apical pressure (rotary motion);

separation from manufacturing defect is rare

Question 2

“Managing endodontic instrument separation” by McCoy,

where are NiTi files designed to break?

Answer 2

at the shaft-thank jnctn under extreme force/torque, but it can occur anywhere along the file

Question 3

“Managing endodontic instrument separation” by McCoy,

what should you do if an instrument breaks?

Answer 3

(cry)

take a radiograph, use loupes or surgical microscope for visualization, strong attempts to remove (file braiding, magnetized instruments, ultrasonic endo tips), enlarge access, owner informed, then consider switching to different option

Question 4

“Managing endodontic instrument separation” by McCoy,

what if you can’t get the file out?

Answer 4

can obturate around it (?!) as long as cleaning, shaping is adequate with regular radiographs monitored, can convert to an apico, can extract

Question 5

“Managing endodontic instrument separation” by McCoy,

how often should NiTi files be changed? what about path finders?

Answer 5

3-6 uses;

pathfinder only use once!