When nerve present in the tooth becomes infected or gets damaged, then root canal treatment is done to remove the infection and save the tooth. In case of root canal treatment, infected necrotic pulp portion of tooth is removed and cleaning and shaping of canals is done. After cleaning and shaping of canals, filling of canals is done. During cleaning and shaping of the root canals (Biomechanical preparation), endodontic file breakage is one of the procedural accidents which can occur. There is no direct visibility while performing root canal procedure and an endodontic file can break in root canal if excessive force is applied with file during cleaning and shaping of the canals. If same file has been used many times or improper use of file during cleaning and shaping of canals can lead to breakage of file during biomechanical preparation. If the canals of the tooth are very narrow or are severely crowded, then file can bind to it and break.
If a file breaks during cleaning and shaping of canals, then dentist or endodontist should make an attempt to remove the file from the canal before filling the root canals. Broken file in root canal may or may not cause pain later on. If the root canals are cleaned and sterilized before the endodontic file gets broken, then broken file doesn’t usually cause any symptoms. If endodontic instrument is broken before the canals are sterilized, then it has to be removed before filling of root canals. If broken file is not removed, then it can lead to pain and infection later on. Mild to severe pain or edema in gums surrounding involved tooth after root canal procedure suggests failure of root canal treatment.
Broken Instrument in Left Lower Incisor
If a general dentist is performing the root canal treatment, then he can refer the patient to an endodontist to remove the broken file from the canal. Endodontist is a specialist in root canal treatment and they have an expertise to handle this sort of situations. Fees charged by endodontist for their services will be much more than fees charged by a general dentist. An endodontist will make an attempt to remove the broken endodontic file and will try to bypass it.
If file is not removed and canal is filled, then patient may experience pain months or years after root canal treatment. Pathology beyond broken file can cause pain and infection later on.
If patient experiences pain or discomfort months after root canal treatment, then he should visit his dentist. Dentist will take an x-ray to see cause of pain in root canal treated tooth. If there is broken file present in root canal, then he will refer the patient to an endodontist. Endodontist will remove the broken file and after cleaning of the canals, he will fill the root canals. An endodontist may perform Apicoectomy to remove the broken file from the root canal treated tooth. Apicoectomy refers to surgical removal of apical portion of the tooth.
If broken file can’t be retrieved and root canal treated tooth cause severe pain, then patient is not left with any other option but to extract the tooth. After tooth extraction, patient can get the missing tooth replaced with either dental implants (Best option fore replacement of missing teeth) or dental bridges. If the missing tooth is not replaced and gap is left as it is, then it can lead to misalignment of teeth, chewing problems, esthetics problems and may also lead to periodontal complications.
Success rate of root canal treatment is 90%. In about 10% of cases, complications can occur during or after root canal treatment which can lead to failure of root canal treatment.
Success rate of root canal treatment is 95%. In about 5% of cases, complications may occur after root canal procedure which can lead to failure of root canal treatment.
To avoid further infections after getting root canal treatment and dental crown, it is important that patient maintains good oral hygiene and get regular dental check ups done.
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