Expert consensus on management of instrument separation in root canal therapy
Abstract Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instru...
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2025-06-01
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| Series: | International Journal of Oral Science |
| Online Access: | https://doi.org/10.1038/s41368-025-00372-w |
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| author | Yi Fan Yuan Gao Xiangzhu Wang Bing Fan Zhi Chen Qing Yu Ming Xue Xiaoyan Wang Zhengwei Huang Deqin Yang Zhengmei Lin Yihuai Pan Jin Zhao Jinhua Yu Zhuo Chen Sijing Xie He Yuan Kehua Que Shuang Pan Xiaojing Huang Jun Luo Xiuping Meng Jin Zhang Yi Du Lei Zhang Hong Li Wenxia Chen Jiayuan Wu Xin Xu Jing Zou Jiyao Li Dingming Huang Lei Cheng Tiemei Wang Benxiang Hou Xuedong Zhou |
| author_facet | Yi Fan Yuan Gao Xiangzhu Wang Bing Fan Zhi Chen Qing Yu Ming Xue Xiaoyan Wang Zhengwei Huang Deqin Yang Zhengmei Lin Yihuai Pan Jin Zhao Jinhua Yu Zhuo Chen Sijing Xie He Yuan Kehua Que Shuang Pan Xiaojing Huang Jun Luo Xiuping Meng Jin Zhang Yi Du Lei Zhang Hong Li Wenxia Chen Jiayuan Wu Xin Xu Jing Zou Jiyao Li Dingming Huang Lei Cheng Tiemei Wang Benxiang Hou Xuedong Zhou |
| author_sort | Yi Fan |
| collection | DOAJ |
| description | Abstract Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition. |
| format | Article |
| id | doaj-art-4f0347b4bb8f403aba4f031e4ab10ffe |
| institution | DOAJ |
| issn | 2049-3169 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | International Journal of Oral Science |
| spelling | doaj-art-4f0347b4bb8f403aba4f031e4ab10ffe2025-08-20T02:39:23ZengNature Publishing GroupInternational Journal of Oral Science2049-31692025-06-0117111310.1038/s41368-025-00372-wExpert consensus on management of instrument separation in root canal therapyYi Fan0Yuan Gao1Xiangzhu Wang2Bing Fan3Zhi Chen4Qing Yu5Ming Xue6Xiaoyan Wang7Zhengwei Huang8Deqin Yang9Zhengmei Lin10Yihuai Pan11Jin Zhao12Jinhua Yu13Zhuo Chen14Sijing Xie15He Yuan16Kehua Que17Shuang Pan18Xiaojing Huang19Jun Luo20Xiuping Meng21Jin Zhang22Yi Du23Lei Zhang24Hong Li25Wenxia Chen26Jiayuan Wu27Xin Xu28Jing Zou29Jiyao Li30Dingming Huang31Lei Cheng32Tiemei Wang33Benxiang Hou34Xuedong Zhou35State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityDepartment of Endodontics, Xiangya Stomatological Hospital, Central South UniversityDepartment of Cariology and Endodontics, Wuhan University & State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityDepartment of Cariology and Endodontics, Wuhan University & State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical UniversityDepartment of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral DiseasesDepartment of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental MaterialsDepartment of Endodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology; Shanghai Key Laboratory of StomatologyDepartment of Conservative Dentistry and Endodontics, Shanghai Stomatological Hospital & School of Stomatology, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan UniversityDepartment of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of StomatologyDepartment of Endodontics, School and Hospital of Stomatology, Wenzhou Medical UniversityDepartment of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, College of Stomatology of Xinjiang Medical UniversityInstitute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical UniversityStomatology Hospital, School of Stomatology, Zhejiang University School of MedicineNanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan UniversityDepartment of Endodontics, School and Hospital of Stomatology, Tianjin Medical UniversityDepartment of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical UniversityFujian Key Laboratory of Oral Disease & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical UniversityStomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationDepartment of Endodontics, School and Hospital of Stomatology, Jilin UniversityDepartment of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesJinan Stomatological HospitalHohhot Stomatology HospitalDepartment of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical UniversityCollege & Hospital of Stomatology, Guangxi Medical UniversityDepartment of Endodontics, Affiliated Stomatological Hospital of Zunyi Medical UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityDepartment of Oral Radiology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing UniversityDepartment of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityAbstract Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.https://doi.org/10.1038/s41368-025-00372-w |
| spellingShingle | Yi Fan Yuan Gao Xiangzhu Wang Bing Fan Zhi Chen Qing Yu Ming Xue Xiaoyan Wang Zhengwei Huang Deqin Yang Zhengmei Lin Yihuai Pan Jin Zhao Jinhua Yu Zhuo Chen Sijing Xie He Yuan Kehua Que Shuang Pan Xiaojing Huang Jun Luo Xiuping Meng Jin Zhang Yi Du Lei Zhang Hong Li Wenxia Chen Jiayuan Wu Xin Xu Jing Zou Jiyao Li Dingming Huang Lei Cheng Tiemei Wang Benxiang Hou Xuedong Zhou Expert consensus on management of instrument separation in root canal therapy International Journal of Oral Science |
| title | Expert consensus on management of instrument separation in root canal therapy |
| title_full | Expert consensus on management of instrument separation in root canal therapy |
| title_fullStr | Expert consensus on management of instrument separation in root canal therapy |
| title_full_unstemmed | Expert consensus on management of instrument separation in root canal therapy |
| title_short | Expert consensus on management of instrument separation in root canal therapy |
| title_sort | expert consensus on management of instrument separation in root canal therapy |
| url | https://doi.org/10.1038/s41368-025-00372-w |
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