Separated Instruments - Algorithm of Clinical Decision Making

4.5 (4 votes)

CE Hours: 0

Description: 

Separated instrument is always a stressful situation for clinician. Reasons for separation of Stainless Steel and Nickel-Titanium instrument will be reviewed. Clinical hints for reducing of these unwanted events will be discussed. The influence of separated instrument and their removal on prognosis of endodontically treated tooth will be summarized and clinical procedures will be reviewed. A suggestive algorithm of clinical decision will be proposed, based on the tooth vitality, cleaning and shaping stage, apico-coronal positioning of the separated fragment.The algorithm will deal with the decision making to bypass or retrieve the separated instrument, or choose to leave it with subsequent follow-up and how will it influence the outcome.

  • List possible reasons for instrument separation
  • Evaluate the influence of separated instruments and their removal on the prognosis of endodontically treated tooth
  • Describe a useful decision making algorithm to deal with cases of separated instruments in clinical practice


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Michael Solomonov, D.M.D.

Michael Solomonov, DMD, is an Israeli board certified endodontist and the director of the Postgraduate Endodontic program in Endodontics at the Sheba Medical Center, Tel-Hashomer, IDF, Israel . Dr. Solomonov received his DMD degree at the Tel Aviv University in Israel in 1994, and in 2002 graduated from the 3 years postgraduate program in Endodontology at the Hebrew University – Hadassah in Jerusalem. From 2003 to 2010 Dr. Solomonov served as an clinical instructor at the Hebrew University, Hadassah School of Dental Medicine, Department of Endodontics, Jerusalem. From 2011 he serves as the director of the postgraduate endodontic program in Endodontic department at the Sheba Medical Center, Tel-Hashomer, IDF, Israel. From 2008 Dr. Solomonov is an examiner for the Israeli Board of Endodontics at the Scientific Council of the Israeli Dental Association. He is a member of the American Association of Endodontics (AAE), the European Society of Endodontology (ESE) and the Israeli Endodontic society. Dr. Solomonov has presented and lectured at national and international congresses in Israel, Russia, Greece, Poland, Japan, Italy, Ukraine, Kazakhstan, Kyrgyzstan, Germany, Moldova, Spain, France, Canada, and Slovenia. He has published over 40 articles, as well as textbook on clinical endodontics. Since 1999 he operates a private practice limited to endodontics. He is the founder of the Endodontic Medical Center at the Tel-Aviv metropolis, where he works clinically, alongside board certified endodontists, as well as carries out private courses on contemporary endodontics.

Michael Solomonov, D.M.D.

In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.