Hirani Anoli Jagdishbhai, Arora Ankit, Hadwani Krupali Dhirajlal, Cherian Anu
Department of Conservative and Endodontics, K. M Shah Dental College and Hospital, Munjmahuda, Vadodara, Gujarat, India.
Department of Conservative and Endodontics, Manubhai Patel Dental College and Dental Hospital, Munjmahuda, Vadodara, Gujarat, India.
J Conserv Dent. 2022 Jan-Feb;25(1):105-108. doi: 10.4103/jcd.jcd_303_21. Epub 2022 May 2.
Retreatment of endodontically involved teeth may require the removal of obstruction from root canal space. Instrument fracture is an undesirable and stressful incident which can negatively affect the prognosis of the tooth. Any corrective step taken should be performed with utmost care to prevent extrusion of the fragment into periapex. This case report describes a rare occurrence of movement of a fractured instrument during inter-appointment period. A previously treated left mandibular first molar with a fractured instrument was taken up for retreatment. During the course of treatment, the fractured fragment which was previously located in the apical third of the distal canal was dislodged into the periapical region. However, it was found that fragment moved back inside the canal after the inter-appointment period. The same sequence of events repeated before the instrument could be retrieved. Hydrostatic and vascular pressure build due to periapical inflammation could be cited reasons for such a movement.
对牙髓受累牙齿进行再治疗可能需要清除根管内的阻塞物。器械折断是一件令人不快且有压力的事情，会对患牙的预后产生负面影响。采取的任何纠正措施都应极其小心地进行，以防止碎片挤入根尖周。本病例报告描述了在两次就诊期间折断器械罕见的移动情况。一颗先前治疗过的左下颌第一磨牙，有一根折断的器械，被纳入再治疗。在治疗过程中，先前位于远中根管根尖三分之一处的折断碎片移位到了根尖周区域。然而，发现在两次就诊期间过后，碎片又移回到了根管内。在取出器械之前，同样的一系列事件再次发生。根尖周炎导致的静水压力和血管压力增加可能是这种移动的原因。
