Without seeing her, it sounds like your sister-in-law broke off a file in
the tooth during treatment. Does this happen, yes. It is a risk that can
occur when having any root canal done. If it happened to me (and it has, as
it has to every dentist who has done enough root canals), you stop, inform
the patient what has happened. I would have the patient see an endodontist
in such a situation. I think waiting until June is a bit long since it
sounds like the root canal has been partially done. Perhaps you should get
the full story before having her see one so that you can convey all the
relevant information to the specialist (ie. in which canal did the file
separate, what size file, etc)

As for cost, an endodontist maybe able to remove or just bypass the broken
file, so cost would be the same as for a root canal for that tooth (although
slightly higher given the greater difficulty of this technique as well as
the generally higher fee that a specialist charges).

need some sort of root end surgery. Can't say without seeing or knowing
exactly what happened. I'm sure the endodontist will provide you with an
estimate. Any estimate we give you may be totally off given we don't
exactly know what needs to be done.

J Suljak DDS

I have heard even endodontists recommend that if the canal has been pretty
thoroughly cleaned out and the file fragment is in the apical 1/3 that the
likelihood of success is fairly high.

If this is the case and the tooth is otherwise assymptomatic it may be
worthwhile to do some kind of provisional restoration and wait a while.

I personally am afraid of things like the Maserin kit, and have almost
never been successful removing broken fragments with ultrasonics. I have
sometimes been able to bypass broken files, but the danger is always
creating a new canal. Yes, if in doubt, I refer.

in which canal did the file
separate, what size file, etc)


I love that word "separate".

It is the correct terminology.

I have heard even endodontists recommend that if the canal has been
pretty thoroughly cleaned out and the file fragment is in the apical 1/3
that the likelihood of success is fairly high. If this is the case and
the tooth is otherwise assymptomatic it may be worthwhile to do some
kind of provisional restoration and wait a while.

I personally am afraid of things like the Maserin kit, and have almost
never been successful removing broken fragments with ultrasonics. I
have sometimes been able to bypass broken files, but the danger is
always creating a new canal. Yes, if in doubt, I refer.

Steve

On Wed, 17 Jan 2007 14:53:29 GMT, Mark & Steven Bornfeld <bornfeldmung@dentaltwins.com> wrote:


in which canal did the file

separate, what size file, etc)


I love that word "separate".

It is the correct terminology.

I have heard even endodontists recommend that if the canal has been
pretty thoroughly cleaned out and the file fragment is in the apical 1/3
that the likelihood of success is fairly high. If this is the case and
the tooth is otherwise assymptomatic it may be worthwhile to do some
kind of provisional restoration and wait a while.


Generally this is true, and with NiTi there is no corrosion.

I personally am afraid of things like the Maserin kit, and have almost
never been successful removing broken fragments with ultrasonics. I
have sometimes been able to bypass broken files, but the danger is
always creating a new canal. Yes, if in doubt, I refer.

Steve


OK I give, what's a Maserin Kit ?

Are you using an endodontic ultrasonic ?

Bypassing an possibly removing separated instruments are largely
a function of the type of instrument that has separated and the location.

Have been able to remove some, but it is very time consuming.
If you can bypass it, you can still get good obturation and may
be able to remove the fragment.

This is a good reason to toss endo files frequently, perhaps after one
or two cases. And yes, I mean *both* rotary and hand files.
IMO you can't detect metal fatigue until it's too late.

Using a different id through google groups, at work... but this is
JimSocal:
Thanks for all the feedback.

Apparently the file broke off after the root canal treatment was done,
that is the root canal does not need to be finished.

the size of the file from my wife, but she has an appt. with an
endodontist on Friday.

So what you are saying is that sometimes it IS alright to leave the
file inside?

Thanks to all for the help.

Newbie wrote:

On Wed, 17 Jan 2007 14:53:29 GMT, Mark & Steven Bornfeld <bornfeldmung@dentaltwins.com> wrote:


in which canal did the file

separate, what size file, etc)


I love that word "separate".

It is the correct terminology.


Me too. The wiseguys in Brooklyn have taken to saying "I'm gonna
separate your face".


I have heard even endodontists recommend that if the canal has been
pretty thoroughly cleaned out and the file fragment is in the apical 1/3
that the likelihood of success is fairly high. If this is the case and
the tooth is otherwise assymptomatic it may be worthwhile to do some
kind of provisional restoration and wait a while.


Generally this is true, and with NiTi there is no corrosion.

There probably isn't much with stainless steel either. But with NiTi
it's of course less likely you're zipping an apex, so in a curved canal
I think it's likely it would break less.
I'm also guessing you don't break many NiTi instruments because you
ain't cheap.

I personally am afraid of things like the Maserin kit, and have almost
never been successful removing broken fragments with ultrasonics. I
have sometimes been able to bypass broken files, but the danger is
always creating a new canal. Yes, if in doubt, I refer.

Steve


OK I give, what's a Maserin Kit ?

Sorry, I misspelled it. Here is a brief description:

http://www.micro-mega.com/anglais/produits/masseran/index.php

Are you using an endodontic ultrasonic ?

No I'm not, and I use perio ultrasonic largely for fractured posts or
peeso/gates gliddens. I'm no apex boy. I leave that to the specialists.

If so, which one ?

Bypassing an possibly removing separated instruments are largely
a function of the type of instrument that has separated and the location.

Have been able to remove some, but it is very time consuming.
If you can bypass it, you can still get good obturation and may
be able to remove the fragment.

This is a good reason to toss endo files frequently, perhaps after one
or two cases. And yes, I mean *both* rotary and hand files.
IMO you can't detect metal fatigue until it's too late.


I agree 100%.

Happy New Year!

Steve


Same to ya !

On Wed, 17 Jan 2007 16:30:36 GMT, Mark & Steven Bornfeld <bornfeldmung@dentaltwins.com> wrote:


Newbie wrote:


On Wed, 17 Jan 2007 14:53:29 GMT, Mark & Steven Bornfeld <bornfeldmung@dentaltwins.com> wrote:



in which canal did the file


separate, what size file, etc)


I love that word "separate".


It is the correct terminology.


Me too. The wiseguys in Brooklyn have taken to saying "I'm gonna
separate your face".


I have heard even endodontists recommend that if the canal has been
pretty thoroughly cleaned out and the file fragment is in the apical 1/3
that the likelihood of success is fairly high. If this is the case and
the tooth is otherwise assymptomatic it may be worthwhile to do some
kind of provisional restoration and wait a while.


Generally this is true, and with NiTi there is no corrosion.

There probably isn't much with stainless steel either. But with NiTi
it's of course less likely you're zipping an apex, so in a curved canal
I think it's likely it would break less.
I'm also guessing you don't break many NiTi instruments because you
ain't cheap.


I look at it this way, what is cheaper, new endodontic instruments or
the cost of a potential RCT failure due to separation ?
It's a no brainer. I routinely go through several 6, 8 files in some molar
cases. For NiTi, if it gets torqued it gets tossed. Especially in closed bi's
and almost all molars one case is more than plenty.


Suspect that most toss carbide or diamond burs after only a few uses, same applies to files.
Toss 'em ! Frequently ! I say !!!
When in doubt, throw it out.
not to be confused with Ted Nugent's philosophy>

I personally am afraid of things like the Maserin kit, and have almost
never been successful removing broken fragments with ultrasonics. I
have sometimes been able to bypass broken files, but the danger is
always creating a new canal. Yes, if in doubt, I refer.

Steve


OK I give, what's a Maserin Kit ?

Sorry, I misspelled it. Here is a brief description:

http://www.micro-mega.com/anglais/produits/masseran/index.php


Kewl, am gonna consult with Dr. Endo about this before I buy one.


Are you using an endodontic ultrasonic ?

No I'm not, and I use perio ultrasonic largely for fractured posts or
peeso/gates gliddens. I'm no apex boy. I leave that to the specialists.



Alas, perio ultrasonics are just not designed for this application.

If so, which one ?

Bypassing an possibly removing separated instruments are largely
a function of the type of instrument that has separated and the location.

Have been able to remove some, but it is very time consuming.
If you can bypass it, you can still get good obturation and may
be able to remove the fragment.

This is a good reason to toss endo files frequently, perhaps after one
or two cases. And yes, I mean *both* rotary and hand files.
IMO you can't detect metal fatigue until it's too late.


I agree 100%.

Happy New Year!

Steve


Same to ya !

D.K. wrote:

Using a different id through google groups, at work... but this is
JimSocal:
Thanks for all the feedback.

Apparently the file broke off after the root canal treatment was done,
that is the root canal does not need to be finished.

I don't understand what you're saying here. Instrumentation was completed?


Not sure what I mean. As I understand it, the root canal procedure was