MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW

"Background: Instrument separation during endodontic therapy remains a significant clinical challenge, often impacting treatment outcomes. Despite advances in metallurgy and instrument design, file fracture continues to be unpredictable. Objective: This review explores the contributing factor...

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Main Authors: Tareq Hajaj, Paul Freiman, Serban Talpos Niculescu, Mihai Rominu, Tiberiu Hosszu, Ioana Veja
Format: Article
Language:English
Published: Romanian Society of Oral Rehabilitation 2025-06-01
Series:Romanian Journal of Oral Rehabilitation
Online Access:https://rjor.ro/management-of-intracanal-separated-instruments-factors-contributing-to-endodontic-file-separation-a-narrative-review/
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author Tareq Hajaj
Paul Freiman
Serban Talpos Niculescu
Mihai Rominu
Tiberiu Hosszu
Ioana Veja
author_facet Tareq Hajaj
Paul Freiman
Serban Talpos Niculescu
Mihai Rominu
Tiberiu Hosszu
Ioana Veja
author_sort Tareq Hajaj
collection DOAJ
description "Background: Instrument separation during endodontic therapy remains a significant clinical challenge, often impacting treatment outcomes. Despite advances in metallurgy and instrument design, file fracture continues to be unpredictable. Objective: This review explores the contributing factors to file separation, evaluates current management strategies, and outlines preventive measures to enhance clinical success. Methods: A narrative review of literature from PubMed, Scopus, and Google Scholar using keywords including ""endodontic file separation,"" ""fractured instruments,"" and ""retrieval techniques"". Articles published between 2000 and 2025 (41 articles reviewed) were included. Studies were selected based on relevance, recency, and clinical applicability. Inclusion criteria included clinical studies, reviews, and case series addressing separated instrument management; exclusion criteria involved non-English studies and in vitro-only reports. Results: Contributing factors include torsional and cyclic stress, inadequate access, overuse of files, and canal complexity. Management strategies include conservative retention, bypassing, and complete retrieval, often under magnification and ultrasonic assistance. Preventive measures are critical in mitigating risk. Conclusion: A comprehensive understanding of fracture mechanisms and management options can guide clinicians in optimizing endodontic outcomes while preserving tooth integrity. Future perspectives include the use of guided endodontics and AI-assisted detection of high-risk canals."
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institution Kabale University
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publishDate 2025-06-01
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spelling doaj-art-56a64765ceed4b32a9b55a89b9fda9f92025-08-21T08:25:03ZengRomanian Society of Oral RehabilitationRomanian Journal of Oral Rehabilitation2066-70002601-46612025-06-01172993100410.62610/RJOR.2025.2.17.90MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEWTareq Hajaj0Paul Freiman1Serban Talpos Niculescu2Mihai Rominu3Tiberiu Hosszu4Ioana Veja5Department of Prostheses Technology and Dental Materials, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, RomaniaDepartment of Dental Medicine, Faculty of Dentistry, “Vasile Goldis” Western University of Arad, Str. Liviu Rebreanu 86, 310045 Arad, RomaniaDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, RomaniaDepartment of Prostheses Technology and Dental Materials, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, RomaniaDepartment of Dental Medicine, Faculty of Dentistry, “Vasile Goldis” Western University of Arad, Str. Liviu Rebreanu 86, 310045 Arad, RomaniaDepartment of Dental Medicine, Faculty of Dentistry, “Vasile Goldis” Western University of Arad, Str. Liviu Rebreanu 86, 310045 Arad, Romania"Background: Instrument separation during endodontic therapy remains a significant clinical challenge, often impacting treatment outcomes. Despite advances in metallurgy and instrument design, file fracture continues to be unpredictable. Objective: This review explores the contributing factors to file separation, evaluates current management strategies, and outlines preventive measures to enhance clinical success. Methods: A narrative review of literature from PubMed, Scopus, and Google Scholar using keywords including ""endodontic file separation,"" ""fractured instruments,"" and ""retrieval techniques"". Articles published between 2000 and 2025 (41 articles reviewed) were included. Studies were selected based on relevance, recency, and clinical applicability. Inclusion criteria included clinical studies, reviews, and case series addressing separated instrument management; exclusion criteria involved non-English studies and in vitro-only reports. Results: Contributing factors include torsional and cyclic stress, inadequate access, overuse of files, and canal complexity. Management strategies include conservative retention, bypassing, and complete retrieval, often under magnification and ultrasonic assistance. Preventive measures are critical in mitigating risk. Conclusion: A comprehensive understanding of fracture mechanisms and management options can guide clinicians in optimizing endodontic outcomes while preserving tooth integrity. Future perspectives include the use of guided endodontics and AI-assisted detection of high-risk canals." https://rjor.ro/management-of-intracanal-separated-instruments-factors-contributing-to-endodontic-file-separation-a-narrative-review/
spellingShingle Tareq Hajaj
Paul Freiman
Serban Talpos Niculescu
Mihai Rominu
Tiberiu Hosszu
Ioana Veja
MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
Romanian Journal of Oral Rehabilitation
title MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
title_full MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
title_fullStr MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
title_full_unstemmed MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
title_short MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
title_sort management of intracanal separated instruments factors contributing to endodontic file separation a narrative review
url https://rjor.ro/management-of-intracanal-separated-instruments-factors-contributing-to-endodontic-file-separation-a-narrative-review/
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