Yes, IF a canal has been thoroughly
debrided, a "separated" file may well be retained without harm.  But
this should not be posited as "accepted" technique.  Some broken files
are unavoidable; but the vast majority can be avoided by using
instruments as they are designed to be used, and not using them past
their useful life.  This is particularly true for NiTi files, which
show
little sign of fatigue before breaking.

Steve
____________________________

I have to agree with Dr. Bornfeld. The presence of two different pieces
of files, in two different canals, indicates a problem.

- dentaldoc

While I agree that a separated instrument may not the most ideal
obturation material, there is the technic of intentionally using an
endodontic instrument as part of the RC fill.

NiTi doesn't corrode, so if it's in the canal tightly, and there
is no leakage, things will likely be OK.

NiTi instruments should be considered 'single use' instruments.
One molar case and discard. In very small canals 6, 8, 10
hand files should be used to start, then enlarge the canal to a 20
before introducing NiTi rotary instruments.
This is likely less important than using new instruments
for every case.

BTW I often discard many 6, 8, and 10's during a single case but the
newer stiffer files don't 'kink' as easily. Besides, new instruments
cut more efficiently and are less likely to separate.

Steven Bornfeld Wrote:

Katelyn

Files do break sometimes.  Unanticipated file separation, fracture,  o
breakage (whatever you want to call it), is not all that uncommon

In fact, this is usually an accidental complication and not a
anticipated  technique for obturation.  In other words, using a portio
of the file to permanently plug-up a debrided canal as Newbie ha
suggested, is generally not the norm in RCT.

With that said however,  when a file does separate, the endodontist ma
decide that the best course is to leave the fragment in the canal, a
sometimes there is more risk involved in trying to remove the piece.
This idecision is made on a case-by-case basis

The fact that the 2 files separated in your situation, does not mea
your endodontist is incompetent.  IMHO, it just means she was unlucky.
It may prompt her to change vendors.  

BTW, I count stitches too.  Thank you for elaborating. :)

It sounds like the surgeon has taken care of things. Good luck an
please keep us posted

Here is some additional information for you

http://www.endoexperience.com/fax-JulyAugSept04.ht

--
drdolittl

Steven Bornfeld Wrote:

Steve

Just had a conversation with a Canadian dentist (on another forum).
Apparently there is an old technique (of the silver cone era, 1940s
where a file is purposely left in as an obturant, like a silver cone

However today is not generally an accepted technique.  In fact I hav
read some literature (abstracts form Pubmed)  where some of these hav
later needed removal due to subsequent sequelae

Best

drdo-very-little :-

--
drdolittl