Case Description

This case had a separated instrument in the  distal canal.

The instrument turned out to be a barbed broach which can be quite tricky to remove due to it being firmly lodged in the canal and binding at different points.

Here, it was retrieved using Hedstrom files and the braiding technique.

Interestingly the periapical lesion is mainly around the distal/palatal root – the only two roots that had some obturation material in it. The mesial root (2 canals) although untouched/cleaned, did not have any obvious periapical pathology!

This shows us that we can easily introduce bacteria into the canals and cause pathology!

The dentist likely did not use rubber dam, used a barbed broach in the emergency appointment and when they realised it came out shorter than when it went it, the tooth was hastily obturated and filled. I wonder why it had an onlay placed in the state that it was!