MICROSCOPIC REMOVAL OF A BROKEN NICKEL-TITANIUM FILE PROTRUDING FROM A ROOT APEX ALONG THE MAXILLARY SINUS FLOOR

Abstract

A patient was referred to our department complaining of the appearance and persistence of occlusal and percussion pain after pulp extirpation, with X-rays showing a radiopacity protruding from the apical foramen. Panoramic and dental X-rays showed a foreign body, and the fracture surface of a broken instrument was visible in the apical one-third of the mesiobuccal root under microscopy. However, the broken piece was firmly wedged. Computed tomography showed that it extended close to the maxillary sinus floor. The fracture surface of the foreign object in the root canal was subjected to ultrasound vibration under rubber dam isolation, and on the third visit, it became possible to move it, after which it was grasped with a stainless-steel wire loop and removed under traction. Lateral condensation root canal filling was then performed, and the patient’s subsequent course has been uneventful.