REMOVAL OF AN INSTRUMENT IN THE MIDDLE AND APICAL THIRD OF THE MESIOLINGUAL CANAL OF THE LOWER MOLAR USING THE BYPASS TECHNIQUE

Abstract

The objective of this study was to describe a case fractured in the middle and apical third of the mesial canal of the lower molar by the bypass technique. The patient was referred to a private practice for endodontic retreatment of tooth 46. After removal of gutta-percha In the first session, it was decided to completely unfill the buccal canal using a reciprocating file (Reeciproc R#25, with the aid of 2% chlorhexidine + natrosol. Patency was achieved with the use of an Easy 15.05 rotary file at 400 rpm and torque of 1 N. The fragment was not located through microscopy. Therefore, it was decided to try to pass the fragment with file #15.02 C-Pilot since the biological cost of the removal attempt was considerable. It was decided to fill the canal with Bio-C Sealer cement, using the injectable technique to obtain an apical puff, locking the tip inside the canal and exerting positive pressure. An X-ray was performed to verify whether the cement would overcome the obstruction. It is concluded that the instrument bypass technique is a conservative and effective maneuver and an adequate solution in cases of fracture of endodontic files in the apical and middle third of the root canal.