Yoshitsugu Terauchi D.D.S., PhD.
Dr. Terauchi is a part-time lecturer at Tokyo Medical & Dental University and maintains a private practice limited to endodontics since 1998. He earned his DDS in 1993 and completed his residency at Tokyo Medical & Dental University in 1995, where he also received his PhD from the Department of Endodontics. He has published several articles in peer- reviewed journals nationally and internationally. He also authored in several chapters in textbooks including the 11th edition of Pathways of the Pulp. He has lectured nationally and internationally and was exposed twice on National TV, for modern endodontics.
Yamato-Shi ,Kanagawa 242-0001
Removal of a Separated Instrument
Topic: Nonsurgical Endodontic Treatment & RetreatmentLearning Objectives:
At the conclusion of this presentation, participants should be able to:
- Describe how an endodontic instrument fractures
- Create a treatment plan for broken instrument removal
- Explain the concept of broken file removal
- Prepare the canal for broken instrument removal
- Demonstrate removal a broken instrument from the canal
One of the iatrogenic accidents in endodontic treatment is an instrument fracture within the root canal system. The majority of instruments fractured in root canals are reported to be NiTi. The literature shows the majority of NiTi instruments fracture, unfortunately, in the apical one-third or beyond a curve in the canal because of the superelastic property. An instrument fracture is very frustrating and instrument retrieval is considered to be even more challenging in endodontics than any other part of endodontic procedure. In addition, the instrument fracture immediately hinders the clinician from performing further treatment, and thus the outcome of the treatment will be compromised. Although the success rates of instrument retrieval with ultrasonics are in the range of 80 to 90 %, ultrasonic retrieval has never been 100 % successful and it is deemed to be unpredictable in terms of time and dentin sacrifice. Ultrasonic removal attempts especially from the apical one third of a curved canal often result in a significant amount of dentin sacrifice. On top of that, aggressive use of ultrasonics could lead to perforation and secondary fracture especially around a curve because there is no standardized technique for successful instrument retrieval. Therefore, In the lecture or the workshop a standardized technique is suggested to retrieve a broken file to both maximize the success and minimize dentin sacrifice without causing iatrogenic events as it has been developed using a novel instrument retrieval kit. The recent literature has shown that the instrument retrieval with this technique was predictable and was significantly more successful and more conservative in dentin sacrifice than that with ultrasonics. The unique procedures in combination with CBCT for instrument retrieval will also be shown and discussed using contemporary concepts.
Half day lecture, workshop, or live demo.
Disclosed consulting position to develop the end design of a product in which 10% royalties are received.