Department of Operative Dentistry and Endodontics Department of Oral Radiology Department of Oral and Maxillofacial Surgery School of Stomatology, Fourth Military Medical University, Xi'an, China.
Int Endod J. 2010 Dec;43(12):1143-51. doi: 10.1111/j.1365-2591.2010.01780.x.
To present a case that used spiral computerized tomography (CT) to locate and successfully remove a fractured endodontic instrument lying beyond the apical foramen using a surgical approach.
The fracture of an endodontic instrument beyond the apical foramen is rare. In this case report, after an attempt to remove a fractured instrument failed, a multi-slice spiral computerized tomography (MSCT) was used for diagnosis and treatment planning. The fractured segment was precisely located and found in the soft tissue and successfully removed by surgery. For the successful removal of a fractured endodontic instrument beyond the apical foramen, the following are necessary: (i) knowledge of the cause of fracture and how to plan treatment; (ii) determining the precise location of the fractured segment using CT; and 3) skilful operation.
• Fractured endodontic instruments might lie within the soft tissue. • Computerized tomography is an effective diagnostic aid for localizing the precise position of fractured instruments.
通过手术途径，利用螺旋计算机断层扫描（CT）定位并成功取出超出根尖孔的折断根管器械。
根管器械在根尖孔外折断是罕见的。在本病例报告中，在尝试取出折断器械失败后，使用多层螺旋 CT（MSCT）进行诊断和治疗计划。准确地定位了折断的部位，并在软组织中发现了它，并通过手术成功地取出。对于成功取出超出根尖孔的折断根管器械，需要以下几点：（i）了解折断的原因和治疗计划；（ii）通过 CT 确定折断部位的准确位置；以及（iii）熟练的操作。
•折断的根管器械可能位于软组织内。
•计算机断层扫描是定位折断器械精确位置的有效诊断辅助手段。
