SP-35 Removing Separated Instruments: Techniques and the Decision-Making Process, SP-36 A New Surgical Technique to Remove Fractured Files from the Apical Third of Curved Root Canals Based on the Apical Third Conservation, and SP-37 Removal of and Cleanin

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CE Credit: 1.5

SP-35 Removing Separated Instruments: Techniques and the Decision-Making Process

In the event of endodontic instrument separation, the endodontist has to be prepared to manage this difficult clinical situation. The clinical decision should be based on a thorough knowledge of the success rates for each treatment option and the risks associated with them. Technological advancements, like the operating microscope, piezoelectric ultrasonic units with different-sized tips and instrument removal systems, have significantly increased the predictability of removing separated instruments with different success rates. Clinical cases showing removal techniques will be presented with factors that influence the clinical decision making. Finally, some examples of managing the situation with the patient and the referring dentist will be addressed.

At the conclusion, participants should be able to:

  • Discuss the prognosis of each treatment option after separating an instrument into the canal and the decision-making process.
  • Explain different ways to manage the situation with the patient and the referring dentist.

SP-36 A New Surgical Technique to Remove Fractured Files from the Apical Third of Curved Root Canals Based on the Apical Third Conservation

Removing fractured files below the curvature of root canals can be extremely inaccessible, causing great wear and even deviation while trying to remove it, especially in highly curved roots. In this context, a new proposal was designed, based on the removal of fractured instruments by surgical access without removing the apical third or promoting excessive wear. After the confirmation of the surgical need with the diagnosis from clinical observations and CBCT, a surgical access is performed for the exposure of the root apex. Ultrasonic tips are used to promote a parallel cut with the long axis of the root, exposing the fractured instrument (window access). The canal is filled with gutta-percha and the window access with MTA or bioceramics (similar to an external resorption treatment). Clinical reports followed radiographically will be used to illustrate the technique and demonstrate its excellent prognosis.

At the conclusion, participants should be able to:

  •  Demonstrate a new technique to remove fractured instruments below high curvatures in the root canal.
  •  Discuss different approaches of the treatment

SP-37 Removal of and Cleaning Around and Beyond Separated Instruments Using the Multisonic Technology

Separated instruments in root canals have the potential to compromise endodontic treatment as they prevent access to the apex and thereby impede thorough cleaning, shaping and sealing of the root canal system. Removing or bypassing a separated instrument in the apical third, especially curved roots, is almost impossible. In a case of successful removal, many complications are possible including, but not limited to, excessive removal of root dentin and root perforations. For symptomatic and/or infected root canal space, where removal was not possible, the clinician has only the options of apical surgery or extraction. The aims of this study were to investigate the success rate of removal of separated instruments from the middle and apical thirds of extracted molar teeth using broad spectrum sonic waves while maximally conserving the dentinal structure, and to explore the possible effect of the broad spectrum sonic waves on the canal space beyond instruments that were not successfully removed.

At the conclusion, participants should be able to:

  •  Evaluate current methods utilized for removing separated instruments.
  •  Discuss the limitations of current methods.
  •  Assess the capability of the GentleWave™ System and different endodontic treatment approaches in removing separated instruments

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SP-35 Removing Separated Instruments: Techniques and the Decision-Making Process
MP3 Audio
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Presentation
Open to view video.
Evaluation
7 Questions
CE Test
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass
SP-36 A New Surgical Technique to Remove Fractured Files from the Apical Third of Curved Root Canals Based on the Apical Third Conservation
MP3 Audio
Open to listen to or download MP3 audio.
Open to listen to or download MP3 audio.
Presentation
Open to view video.
Evaluation
7 Questions
CE Test
6 Questions  |  Unlimited attempts  |  5/6 points to pass
6 Questions  |  Unlimited attempts  |  5/6 points to pass
SP-37 Removal of and Cleaning Around and Beyond Separated Instruments Using the Multisonic Technology
MP3 Audio
Open to listen to or download MP3 audio.
Open to listen to or download MP3 audio.
Presentation
Open to view video.
Evaluation
7 Questions
CE Test
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass
Certificate
1.50 CE credits  |  Certificate available
1.50 CE credits  |  Certificate available

André G. Machado, D.D.S.

Graduated in Dentistry by Estacio de Sa University Center in Juiz de Fora-MG (with final grade average A) with complete tutoring of Radiology, two consecutive tutoring in Endodontics I and one in Endodontics II. Currently attending Residency and Masters in Edodontics at Estacio de Sa University. Scientific focus on academic activities connecting endodontic research and the clinical practice.

André G. Machado, D.D.S.

Disclosure: I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.

Asgeir Sigurdsson, D.D.S., M.S.

Disclosure: In accordance with this policy, I declare I have a 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, as indicated below:
Sonendo Inc. (Self) : Consultant (Status: Ongoing), Stockholder/Ownership Interest (excluding diversified mutual funds) (Status: Ongoing)