LL6 broken file: Distal Canal
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Bypassing or removing fractured instruments in the distal canal of a lower molar
Overview
In this video, We discuss the management of a fractured size 10 file in the distal canal of a mandibular first molar. We highlight the importance of 3D imaging for assessment and evaluate the clinical decision-making process between bypassing and removing an obstruction to ensure successful root canal disinfection.
The Case & History
A 27-year-old healthy female was referred for primary root canal treatment following a procedural complication where a size 10 file tip fractured and became lodged in the distal canal. The patient has been fully informed and seeks a solution to either bypass or retrieve the instrument to allow the treatment to be completed. Radiographic assessment shows no evidence of periapical pathology, and the distal canal appears relatively wide, which may influence the choice of management strategy.
The Clinical Problem
The clinician is seeking expert advice on the specific armamentarium and techniques required to bypass the fractured instrument. The primary concern is determining the most predictable way to navigate around the size 10 file without further complicating the canal anatomy or pushing the fragment deeper, especially in a canal that has already been prepared significantly.