Modern approach to treatment of teeth with a fragment of an endodontic instrument in the apical third of the root canal or beyond its boundaries

Background. Given the complex and diverse anatomy of root canals and the properties of modern endodontic instruments, one of the main problems in dentistry remains instrument breakage in the root canal during the treatment of complicated caries. Purpose – to analyze the existing literature data and the experience of own clinical observations and to determine effectiveness of the modern approach to the treatment of chronic periodontitis in the presence of a broken endodontic instrument fragment in the apical third of the root canal or beyond. Materials and Methods. Based on the study of the literature and oneʼs own clinical observations, the existing data on the modern approach to the treatment of chronic periodontitis in the presence of an endodontic instrument fragment in the apical third of the root canal or beyond it were analyzed. The list of analyzed sources of special literature included: periodicals for the last years and monographs without a statute of limitations, as well as case histories from oneʼs own clinical observations. The descriptive method was used to conduct the analysis. Four clinical cases from our own practice are described, in which secondary endodontic treatment was performed in the presence of dental instruments fragments in the lower third of the root canal or outside the root apex. Results. Secondary endodontic treatment of inflammatory processes in the teeth periapical tissues, in which fragments of endodontic instruments are visualized in the apical third of the root canal or outside it, and subsequent observation had positive dynamics and a stable result of periapical tissues bone restoration. Conclusions. The data obtained will allow to preserve functionally active teeth and reduce early tooth loss.