Dentin Disruption Minimized with Ultrasonic Tips
This case illustrates how tricky orienting oneself can be in the endodontic canal. While creating a thin space to retrieve the separated file, what appeared to be the inner curve actually turned out to be the outer curve. The separated file length measurement with CBCT suggested that the separated file from DB could be removed with ultrasonics, as it was 1.8 mm on the coronal view. When a separated file is in a straight canal, you can cut a thin space anywhere you like. Upon removal of the root filling, the separated file became visible immediately. Though I created a thin space on what I thought to be the inner wall, the separated file didn’t dance at all with ultrasonics. Then I looked at the CBCT again and I started thinking it was the outer wall. I stopped cutting the mesial wall and turned to the distal wall which turned out to be the inner wall. As soon as I started cutting the distal wall, the separated file danced this time with the ultrasonics. Then, I filled the canal and activated ultrasonics in the “inner” space, successfully dislodging the file. The dentin sacrifice was not significant given the precise accuracy and minimal disruption that the Terauchi File Retrieval Kit offers.