Background: Irrigation is an integral part of successful root canal treatment. Syringe and needle irrigation is an effective method to control microbial flora of the root canal. Needle with multiple vents efficiently delivers irrigating solutions. Geometric configuration of the irrigating needle may predispose it to fracture during irrigation. A fractured needle causes procedural difficulties during treatment. Careful removal of the fragment with minimal tissue loss improves the prognosis of the treatment. Case description: This case report describes the management of a fractured double-side-vented irrigating needle within the mesiobuccal canal orifice of maxillary first molar. The separated fragment was successfully retrieved with the help of indirect ultrasonics under magnification with a dental operating microscope. Conclusion: Development in techniques and armamentarium has led to successful retrieval of separated fragment from the root canal. The selection of a suitable method according to the position of the fractured instrument facilitates retrieval with minimal tissue removal.
Kahn FH, Rosenberg PA, Gliksberg J. An in vitro evaluation of the irrigating characteristics of ultrasonic and subsonic handpieces and irrigating needles and probes. J Endod 1995;21(5):277–280. DOI: 10.1016/S0099-2399(06)80998-2.
Boutsioukis C, Verhaagen B, Versluis M, et al. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010;36(5):875–879. DOI: 10.1016/j.joen.2009.12.026.
Goldman M, Kronman JH, Goldman LB, et al. New method of irrigation during endodontic treatment. J Endod 1976;2(9):257–260. DOI: 10.1016/S0099-2399(76)80085-4.
Teplitsky PE, Chenail BL, Mack B, et al. Endodontic irrigation–a comparison of endosonic and syringe delivery systems. Int Endod J 1987;20(5):233–241. DOI: 10.1111/j.1365-2591.1987.tb00620.x.
Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 2010;43(8):663–672. DOI: 10.1111/j.1365-2591.2010.01723.x.
Boutsioukis C, Lambrianidis T, Verhaagen B, et al. The effect of needle insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 2010;36(10):1664–1668. DOI: 10.1016/j.joen.2010.06.023.
Zairi A, Lambrianidis T. Accidental extrusion of sodium hypochlorite into the maxillary sinus. Quintessence Int 2008;39(9):745–748.
Vinothkumar TS, Kavitha S, Lakshminarayanan L, et al. Influence of irrigating needle-tip designs in removing bacteria inoculated into instrumented root canals measured using single-tube luminometer. J Endod 2007;33(6):746–748. DOI: 10.1016/j.joen.2007.02.013.
Strindberg L. The dependence of the results of pulp therapy on certain factors: an analytic study based on radiographic and clinical follow up examination. Acta Odontol Scand 1956;14(Suppl 21):1–175.
Suter B, Lussi A, Sequeira P. Probability of removing fractured instruments from root canals. Int Endod J 2005;38(2):112–123. DOI: 10.1111/j.1365-2591.2004.00916.x.
Saunders JL, Eleazer PD, Zhang P, et al. Effect of a separated instrument on bacterial penetration of obturated root canals. J Endod 2004;30(3):177–179. DOI: 10.1097/00004770-200403000-00012.
Madarati AA. Retrieval of multiple separated endodontic instruments using ultrasonic vibration. J Taibah Univ Med Sci 2016;11:268–273. DOI: 10.1016/j.jtumed.2015.11.010.
Ingle JI, Himel VT, Hawrish CE, et al. Endodontic cavity preparation. In: Ingle JI, Bakland LK. Endodontics. 5th ed., Ontario: BC Decker; 2002. p. 502.
Sedgley CM, Nagel AC, Hall D, et al. Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 2005;38(2):97–104. DOI: 10.1111/j.1365-2591.2004.00906.x.
Nevares G, Cunha RS, Zuolo ML, et al. Success rates for removing or bypassing fractured instruments: a prospective clinical study. J Endod 2012;38(4):442–444. DOI: 10.1016/j.joen.2011.12.009.
Plotino G, Pameijer CH, Grande NM, et al. Ultrasonics in endodontics: a review of the literature. J Endod 2007;33:81–95. DOI: 10.1016/j.joen.2006.10.008.
Ward JR, Parashos P, Messer HH. Evaluation of an ultrasonic technique to remove fractured rotary nickel–titanium endodontic instruments from root canals: an experimental study. J Endod 2003;29(11):756–763. DOI: 10.1097/00004770-200311000-00017.