A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing

The ideal retrieval protocol of separated instruments reverts the case to the initial situation prior to the fracture incidence while preserving the tooth hard tissue and the integrity of the supporting structures. When a patient presented for emergency treatment of tooth #37 diagnosed with acute su...

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Main Authors: Ahmed Elhakim, Tarek Mohamed Abd El-Wahab
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Dentistry
Online Access:http://dx.doi.org/10.1155/2022/2589021
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author Ahmed Elhakim
Tarek Mohamed Abd El-Wahab
author_facet Ahmed Elhakim
Tarek Mohamed Abd El-Wahab
author_sort Ahmed Elhakim
collection DOAJ
description The ideal retrieval protocol of separated instruments reverts the case to the initial situation prior to the fracture incidence while preserving the tooth hard tissue and the integrity of the supporting structures. When a patient presented for emergency treatment of tooth #37 diagnosed with acute suppurative apical periodontitis, radiographic examination revealed a fractured instrument extruded into the periapex. The treatment options for retrieval were limited to replantation. The initial emergency treatment which consisted of orthograde pus drain, radicular disinfection, and intracanal calcium hydroxide dressing completely resolved patient’s symptoms. The follow-up radiographs revealed an interesting finding: gradual shift in the separated fragment position into the radicular space allowing a successful nonsurgical removal of the broken instrument. In conclusion, the reaction of periodontal tissues to an extruded instrument fragment remaining in situ may be favourable; thus, a risk and benefit analysis approach is essential to fractured instrument retrieval.
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series Case Reports in Dentistry
spelling doaj-art-d4fdf98c0ef14916849e199f3519c9712025-02-03T05:53:08ZengWileyCase Reports in Dentistry2090-64552022-01-01202210.1155/2022/2589021A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue HealingAhmed Elhakim0Tarek Mohamed Abd El-Wahab1Department of EndodonticsDepartment of EndodonticsThe ideal retrieval protocol of separated instruments reverts the case to the initial situation prior to the fracture incidence while preserving the tooth hard tissue and the integrity of the supporting structures. When a patient presented for emergency treatment of tooth #37 diagnosed with acute suppurative apical periodontitis, radiographic examination revealed a fractured instrument extruded into the periapex. The treatment options for retrieval were limited to replantation. The initial emergency treatment which consisted of orthograde pus drain, radicular disinfection, and intracanal calcium hydroxide dressing completely resolved patient’s symptoms. The follow-up radiographs revealed an interesting finding: gradual shift in the separated fragment position into the radicular space allowing a successful nonsurgical removal of the broken instrument. In conclusion, the reaction of periodontal tissues to an extruded instrument fragment remaining in situ may be favourable; thus, a risk and benefit analysis approach is essential to fractured instrument retrieval.http://dx.doi.org/10.1155/2022/2589021
spellingShingle Ahmed Elhakim
Tarek Mohamed Abd El-Wahab
A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
Case Reports in Dentistry
title A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
title_full A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
title_fullStr A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
title_full_unstemmed A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
title_short A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing
title_sort rare case of orthograde retrieval of extruded instrument following periapical tissue healing
url http://dx.doi.org/10.1155/2022/2589021
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