Beautiful theme Dr. Nasseh. I appreciate that you try to point out the important aspects of a delicate situation in treatment. You listed the problems: - related to the position of the broken instrument which are very important; and tooth anatomy - the initial diagnosis of the tooth. It is important to note the type of broken instrument and ask why it broke. In the case of rotary needles, you clearly described the situation. If we talk about the manual tools, in the situations I encountered, the manual tools were broken due to improper use. For example: spinning a hoestron needle will cause it to break. It is important to make the sliding path with manual tools. Spinning a needle more than 250 degrees will most likely cause it to break. Back and forth movements, balanced force technique, watch and winding motion are the basis of endodontic treatment. We can't do these movements with all those manuals. For example: the hoedstrom needle will only move back and forth in the channel. I mentioned these things to avoid the unpleasant and difficult situation of breaking a needle in the channel. Returning to today's topic. It should also be mentioned that a CBCT exam is important to observe the thickness of the root wall in the respective area in order to be able to perform at least a bypass if we fail to remove the broken needle. There are areas where the root wall is very thin and the risk of perforation is high. For example, the mesial root of the mandibular 1st molar, distal face. Or the mesio-vestibular root of the maxillary 1st molar, due to the curvature these roots have.
Dr. Nasseh ,can a #30 taper 4 file be bypassed from a mesial narrow canal in lower molar? it's broken at 00 on apex and i did adequate cleaning and shaping beforehand, i tried to bypass using #10 d finder file , but it broke after successfully bypassing half length of the separated instrument.
If it broke when trying to bypass then you answered your own question. It couldn’t be bypassed! As I mentioned I try for a period and then I just fill and monitor. If a lesion was present chance of apicos is explained.
@@AANasseh I would have a question. for bypassing a broken file should I reduce my time spent on bypassing it till 15 min(+fill and monitor)? because i sometimes spend more than 25 min to bypass and usually end up in a ledge and had also perforations. i tried to bypass broken files with activated hand files at the tip(i cut the tip half a mm or one mm) . seems a bad ideea now:( thank you for making this video!
@@cosminhuplea5694 Don’t waste too much time trying to bypass and certainly don’t bypass at the price of perforating! You’re causing. Anew problem on top of the other problem! It’s important to keep the big picture in mind.
Beautiful theme Dr. Nasseh. I appreciate that you try to point out the important aspects of a delicate situation in treatment. You listed the problems:
- related to the position of the broken instrument which are very important; and tooth anatomy
- the initial diagnosis of the tooth.
It is important to note the type of broken instrument and ask why it broke. In the case of rotary needles, you clearly described the situation. If we talk about the manual tools, in the situations I encountered, the manual tools were broken due to improper use. For example: spinning a hoestron needle will cause it to break.
It is important to make the sliding path with manual tools. Spinning a needle more than 250 degrees will most likely cause it to break. Back and forth movements, balanced force technique, watch and winding motion are the basis of endodontic treatment. We can't do these movements with all those manuals. For example: the hoedstrom needle will only move back and forth in the channel.
I mentioned these things to avoid the unpleasant and difficult situation of breaking a needle in the channel.
Returning to today's topic. It should also be mentioned that a CBCT exam is important to observe the thickness of the root wall in the respective area in order to be able to perform at least a bypass if we fail to remove the broken needle. There are areas where the root wall is very thin and the risk of perforation is high. For example, the mesial root of the mandibular 1st molar, distal face. Or the mesio-vestibular root of the maxillary 1st molar, due to the curvature these roots have.
Valuable and helpful video thanks doctor
Very realistic dr. Nasseh
Nicely explained.👍
👍👍
Dr. Nasseh ,can a #30 taper 4 file be bypassed from a mesial narrow canal in lower molar?
it's broken at 00 on apex and i did adequate cleaning and shaping beforehand, i tried to bypass using #10 d finder file , but it broke after successfully bypassing half length of the separated instrument.
If it broke when trying to bypass then you answered your own question. It couldn’t be bypassed! As I mentioned I try for a period and then I just fill and monitor. If a lesion was present chance of apicos is explained.
@@AANasseh Thanks alot
@@AANasseh I would have a question. for bypassing a broken file should I reduce my time spent on bypassing it till 15 min(+fill and monitor)? because i sometimes spend more than 25 min to bypass and usually end up in a ledge and had also perforations. i tried to bypass broken files with activated hand files at the tip(i cut the tip half a mm or one mm) . seems a bad ideea now:( thank you for making this video!
@@cosminhuplea5694 Don’t waste too much time trying to bypass and certainly don’t bypass at the price of perforating! You’re causing. Anew problem on top of the other problem! It’s important to keep the big picture in mind.