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Flowcharting of the Proposed Clinical Decision-Making Algorithm of Broken Endodontic Instruments: Decision-making to Retrieve, Bypass, or Entomb

By  Drs. Nurcan Deniz and  Ekim Onur Orhan Clinical approaches have been described to accessing fractured instruments, depending on their location in the canal and stage of cleaning and shaping (1-3). In the case of root canal instrument fracture, the practitioner has to be well-educated to control the unfortunate situation. The clinical decision-making should be…

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Separation Anxiety? Eleven Tips for Working with NiTi Files

By Joseph C. Stern, D.D.S. There have been few innovations in endodontics as revolutionary as nickel titanium (NiTi) rotary. There was a time when one would spend multiple visits hand filing a canal with stainless steel instruments. This proved to be tedious and quite tiring for the practitioner. That all changed with the advent of…

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Broken Instruments – Clinical Decision Making Algorithm

By Dr. Michael Solomonov The fracture of endodontic instruments during root canal treatment is a complication every endodontist must have to deal with. The reported frequency rate for fractured instruments varies from 0.7% to 6% of cases.1 Stainless steel instrument fracture can be prevented mostly by discarding instruments that show signs of metal fatigue2 however,…

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When a Toothache is Not

A 60-year-old female presents to your clinic with a chief complaint of a “sharp pain in (her) face in the area of the left maxillary second bicuspid”. She indicates that her complaint began approximately one year prior to her consultation with you today. Her symptoms seem to be getting worse over time.

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