Biomaterial Database

Complications associated with fractured file removal using an ultrasonic technique. 2005

Nigel J Souter, and Harold H Messer

Department of Endodontics, School of Dental Science, University of Melbourne, Melbourne, Victoria, Australia.

A technique utilizing modified Gates Glidden burs and ultrasonics has recently been advocated to remove fractured instruments from root canals. Varying extents of tooth structure are removed during this procedure, potentially leading to complications. This study evaluated the in vitro and in vivo complications associated with fractured file removal. Fractured instrument fragments were removed from three different levels (coronal, middle, or apical third) of mesiolingual canals of extracted human mandibular molars. The success rate, frequency of perforations, and root strength were recorded for each group. Perforations and unsuccessful file removal occurred only with fragments lodged in the apical third. Fracture resistance declined significantly with more apically located file fragments. A review of 60 clinical cases showed similar rates of successful file removal and rate of perforations. Removal of a fractured file fragment from the apical third of curved canals should not be routinely attempted.

UI	MeSH Term	Description	Entries
D008866	Microsurgery	The performance of surgical procedures with the aid of a microscope.
D008963	Molar	The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821)	Molars
D003762	Dental Instruments	Hand-held tools or implements especially used by dental professionals for the performance of clinical tasks.	Instrument, Dental,Dental Instrument,Instruments, Dental
D003786	Dental Pulp Cavity	The space in a tooth bounded by the dentin and containing the dental pulp. The portion of the cavity within the crown of the tooth is the pulp chamber; the portion within the root is the pulp canal or root canal.	Pulp Canal,Pulp Chamber,Root Canal,Cavities, Dental Pulp,Cavity, Dental Pulp,Dental Pulp Cavities,Pulp Cavities, Dental,Pulp Cavity, Dental,Canal, Pulp,Canal, Root,Canals, Pulp,Canals, Root,Chamber, Pulp,Chambers, Pulp,Pulp Canals,Pulp Chambers,Root Canals
D004868	Equipment Failure	Failure of equipment to perform to standard. The failure may be due to defects or improper use.	Defects, Equipment,Device Failure,Failure, Equipment,Malfunction, Equipment,Medical Device Failure,Misuse, Equipment,Device Failure, Medical,Device Failures, Medical,Failure, Medical Device,Failures, Medical Device,Defect, Equipment,Device Failures,Equipment Defect,Equipment Defects,Equipment Failures,Equipment Malfunction,Equipment Malfunctions,Equipment Misuse,Equipment Misuses,Failure, Device,Failures, Device,Failures, Equipment,Malfunctions, Equipment,Misuses, Equipment
D005547	Foreign Bodies	Inanimate objects that become enclosed in the body.	Foreign Objects,Gossypiboma,Retained Surgical Instruments,Retained Surgical Items,Retained Surgical Needle,Retained Surgical Sponge,Retained Surgical Tools,Textiloma,Bodies, Foreign,Body, Foreign,Foreign Body,Foreign Object,Gossypibomas,Object, Foreign,Objects, Foreign,Retained Surgical Instrument,Retained Surgical Item,Retained Surgical Needles,Retained Surgical Sponges,Retained Surgical Tool,Surgical Instrument, Retained,Surgical Instruments, Retained,Surgical Item, Retained,Surgical Items, Retained,Surgical Needle, Retained,Surgical Needles, Retained,Surgical Sponge, Retained,Surgical Sponges, Retained,Surgical Tool, Retained,Surgical Tools, Retained,Textilomas
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014082	Tooth Fractures	Break or rupture of a tooth or tooth root.	Fracture, Tooth,Fractures, Tooth,Tooth Fracture
D014092	Tooth Root	The part of a tooth from the neck to the apex, embedded in the alveolar process and covered with cementum. A root may be single or divided into several branches, usually identified by their relative position, e.g., lingual root or buccal root. Single-rooted teeth include mandibular first and second premolars and the maxillary second premolar teeth. The maxillary first premolar has two roots in most cases. Maxillary molars have three roots. (Jablonski, Dictionary of Dentistry, 1992, p690)	Root, Tooth,Roots, Tooth,Tooth Roots
D014465	Ultrasonics	A subfield of acoustics dealing in the radio frequency range higher than acoustic SOUND waves (approximately above 20 kilohertz). Ultrasonic radiation is used therapeutically (DIATHERMY and ULTRASONIC THERAPY) to generate HEAT and to selectively destroy tissues. It is also used in diagnostics, for example, ULTRASONOGRAPHY; ECHOENCEPHALOGRAPHY; and ECHOCARDIOGRAPHY, to visually display echoes received from irradiated tissues.	Ultrasonic