Surgical removal of a fractured endodontic instrument beyond periapex of maxillary lateral incisor using a dental operating microscope: A case report

The introduction of rotary nickel-titanium (NiTi) instruments revolutionized endodontics, enhancing root canal treatment through greater flexibility and procedural efficiency. However, NiTi instruments carry a higher risk of fracture compared to stainless steel files. Instrument separation within the canal can complicate endodontic therapy and may adversely affect prognosis if untreated spaces remain. This case report describes the surgical retrieval of a fractured endodontic instrument extending beyond the apical foramen in a 52-year-old female patient. Under magnification and using precise techniques, the instrument was successfully removed, followed by a one-year follow-up that revealed complete healing. Advanced technologies like operating microscopes, CBCT, and regenerative materials such as platelet-rich fibrin (PRF) significantly improve outcomes by enhancing precision and supporting healing. Despite the potential challenges posed by instrument fractures, successful outcomes can be achieved with meticulous diagnosis, planning, and the use of modern techniques. This case highlights the importance of integrating advanced tools in endodontic practice to optimize treatment results.