Retrieving a Separated Instrument

1. Retrieving a SeparatedInstrument Doug Rakich DDS Power Point Production: Benjamin Schein DDS Based on teachings from Drs. Carr and Ruddle. Some Illustrations from Dr Nahmias www.endoweb.com

2. Mission one is to stage the instrument. With a modified Gates Glidden Drill

3. Titanium CPR’s and high Mag • I used a titanium CPR 6 and 7 under .8 mag on the Global with a Xenon light source.

4. Mission one continued Modified GG staging

5. Mission two is to shake it loose by swirling the tip of the US counterclockwise around the visible fragment.

6. Once the fragment is moving, the real problem is that the coronal end wants to crash into the mesial aspect of the mesial root and does not want to "turn the corner" toward a coronal path of exit. The real problem

7. The trick here is • The trick here is to place the tip of the US between the distal aspect of the fragment and the furcal wall of the canal, flood the canal with bleach and activate.

8. And be careful: • Avoid cutting off the coronal end of the fragment, this can cause you to lose the remainder around a curve. • I don't work the fragment itself so much as try to displace it with the US. • The taper of the instrument results in the development of a vertical force vector to the fragment, while the placement of the US straightens the exit path.  • I use the UC tip like an elevator for a root tip, working vertically against the wall of the tooth  • Sometimes I will put a slight bend on the US tip to facilitate placement. • This straightens the path the instrument must take and the aqueous environment amplifies the vibration while it cools the tooth.

9. Sometimes it even works.