SP-45 Breaks, and Beyond: The Science and Solutions for Endodontic File Fractures
CE Hours: 1.25
Description: Instrument separation remains one of the most complex complications in endodontic practice. This course explores both the science behind file fracture and the innovations designed to prevent it. Attendees will gain a clear understanding of the mechanical and metallurgical factors that lead to separation. The microstructural behavior of NiTi alloys-phase transformations, proprietary heat treatments, and advanced surface processing-will be explained in practical, clinical terms. Equally important, participants will learn predictable strategies for managing separated instruments. Techniques such as CBCT-guided planning, ultrasonic troughing, microtube and loop systems, bypassing, and minimally invasive access will be presented with emphasis on dentin preservation and outcome success. Decision-making protocols will guide clinicians in evaluating case difficulty, preserving dentinal structure, and identifying when surgical intervention is warranted. Designed for endodontic specialists, this evidence-based lecture combines science with practical guidance to equip participants with the skills and confidence to manage instrument separation predictably with minimally invasive access approaches.
Learning Objectives:
- Discuss in-depth the microstructure of Nickel-Titanium (NiTi) alloys and how heat treatment enhances their flexibility and strength, reducing the risk of file fracture
- Gain expertise in advanced techniques and tools, including ultrasonics and retrieval kits, to access and remove separated files effectively using minimally invasive, tooth-preserving approaches.
- Develop strategies to minimize the risk of file breakage during root canal treatment, including proper instrument handling and the use of heat-treated NiTi files.
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LockedWalid Nehme, D.D.S., M.S., Ph.D.
Professor Walid Nehme, DDS, MSc, PhD Associate Professor, University of the Pacific, Arthur A. Dugoni School of Dentistry Professor Walid Nehme is an Associate Professor at the University of the Pacific, Arthur A. Dugoni School of Dentistry, former Head of the Endodontic Department at Saint Joseph University (Beirut), and Invited Professor at Mohamed Bin Rashid University (Dubai). He earned his DDS (1988), MSc in Endodontics (1994), and PhD (2023) from Saint Joseph University. With more than 30 years of clinical and academic experience, Professor Nehme specializes in undergraduate and postgraduate education, research supervision, and advanced training in endodontics. His scholarly work, published in leading peer-reviewed journals, spans root canal anatomy, NiTi file design, instrumentation, irrigation, obturation, and retreatment. Professor Nehme is an international member of the American Association of Endodontists (AAE), past President of the Lebanese Society of Endodontology (LSE), founder and past President of the Arab Endodontic Society (AES), and President-Elect of the Pan Asiatic Endodontic Confederation (APEC). A recognized innovator, he has designed NiTi endodontic files and motors, holding multiple patents and contributing to the development of novel endodontic devices through clinical trials. He actively conducts postgraduate courses and hands-on workshops across the Middle East, Africa, Europe, and Canada. Professor Nehme also maintains a faculty practice limited to endodontics at the University of the Pacific, reflecting his dedication to both patient care and advancing the specialty.
Disclosure(s): coltene: Honorarium (Ongoing), I have developed endodontic files for Micro mega /Coltene and get royalties (Ongoing), Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing)