One of the most troublesome incidents is the fracture of endodontic instruments within root canal. Many objects have been reported to break and subsequently become lodged in root canals.The removal of foreign objects sometimes is difficult and the success rate has been reported as 55% to 79% (20).
Various studies showed that handfiles were the instrument that breaks easily which is similar to our study where dental practitioners believed that handfiles are prone to fracture commonly .Dental practitioners fee that Fracture of instruments usually occurs more in the apical third than in the coronal third and middle third region. The same is proved by various studies.In our study subjects believed that sterilisation reduces the life span of instruments. The study also included a question whether the practitioner will inform the patient or not regarding the instrument fracture and many said that the patient will be informed regarding this issue and any procedure will not be done without the patient’S regard. This question has not been considered in any other studies or surveys. Dental practitioners preferred to retrieve the instrument more than bypassing it or leaving the instrument as it is. In case of fracture beyond the apex they preferred apical Surgery which is one method of retrieving the fractured instrument.
Several methods are described to remove broken instruments or objects within root canals. The evaluation of fractured instrument removal systems and techniques such as the Masserann Kit, (21) Endo Extractor (Brasseler USA Inc., Savannah, GA), (22) wire loop technique, (23) the Canal Finder System (24). (Fa.Societé Endo Technique, Marseille, France), and ultrasonic devices (25).In our survey we have discussed about other retrieval systems like Cyanoacrylate materials , IRS and TFK. But most of them are not aware of the al these techniques. So majority of them preferred to refer the patient to an endodontist and were not very confident to manage by themselves. Awareness about Dental negligence case has also been good and majority of the dental practitioners who participated in the survey have not fractured an instrument in recent times .
Conclusion : Management of instrument separation is a complex issue.Practitioners are well informed and are very much aware about how to handle such a situation .Most of the practitioners want to remove the broken part without causing much discomfort to the patients but lacks training. It would be even more better if they get more training in that aspect.