A follow-up case of one of my instrument separation cases with chronic periapical periodontitis on 44 after a year.
patient was 45 years of age without any significant medical condition.
periapical lesion was due to secondary caries under a previously done composite filling.
so after isolation with rubber dam i had started the root canal.I broke a x1 file (4% tapper 17no ASI) at the apical third where canal become curved towards apex.the reason was after negotiating the canal with hand 10 k file, i skipped the hand 15 k file and used the x1 file instead which is corresponds to 17no file.as the canal was curved at the apex, the file broke.skipping instrument size should be avoided and in case of narrow canal hand preparation should be done upto at least 20 no ASI before approaching to rotary files.
as i m a bypass lover(or can't do retrieval :D) i had bypassed the broken file and prepared the canal manually upto 35 k file.i had used sodium hypoclorite for irrigation after ultrasonic activation.
canal was sealed by gp points and seal apex by warm lateral compaction after initial cold lateral compaction.
i've followed up the patient after 1 year.everything looks good.the periapical lesion has gone.
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