Endodontic surgery in a lower molar affected by root resorption and fractured instrument

Abstract

Endodontic treatment is responsible for cleaning and shaping the root canals after they have been affected by diseases in their pulp. However, some clinical complications that are inherent to the treatment may occur, such as fracture of instruments inside the conduit, perforations, and anatomical anomalies. When this occurs and it is not possible to carry out an endodontic intervention, opt for endodontic surgery. The aim of this study is to report a clinical case of endodontic surgery in a lower molar with a fractured file and resorption process. A patient was assisted who had a necrotic dental element, symptomatic, mesial root with fractured file and distal root with resorption process proven in the initial radiograph. In the first session, anesthesia, access surgery, absolute isolation, irrigation with 2.5% sodium hypochlorite were performed and an attempt was made to remove the fractured instrument with an operating microscope and an ultrasound insert, but this was unsuccessful. In this way, the dental element instrumented with rotary files logic 25/05, dried and filled with thermoplasty technique, using bioceramic cement. In the second session, endodontic surgery was performed with removal of the fractured instrument. A 2-month follow-up was performed, analyzing the pathology and symptomatology regression. The patient was asymptomatic and undergoing tissue repair in the mesial and distal root. It is possible to conclude with this clinical case that endodontic surgery is feasible in cases of fractured instrument and resorption process, thus allowing the remission of the pathological process, paralysis of the infectious process and permanence of the function and aesthetics of the dental element.