RO0111

I 25 case report _ fractured instrument I roots1_2011 limited thickness of the root and the canal’s oval shape.Bypassingwasstartedbyintroducingasize08 D-Finder (Mani Inc.) to the instrument. The D-Finder was used for probing and searching for a way to bypass the instrument. After a few tries, I was able to get the D-Finder past the instrument (Fig. 3). Work- ing length was established using the Root ZX mini (J. Morita) and confirmed radiographically (Fig. 4). The complete shaping sequence of the first appoint- ment is shown in Table I. Duringtheshapingofthecanal,copiousirrigation with5%sodiumhypochloritewasperformed.Patency waskeptwithasize08K-file(ManiInc.)betweenevery instrument. After the canal had been shaped using a size 20 Flexile file (Mani Inc.) and a ProTaper S2 hand file(DENTSPLYMaillefer),calciumhydroxide(Ultracal XS, Ultradent Products Inc.) was placed in the canal and the cavity was sealed with a cotton pellet and a temporary restoration in Fuji IX Fast A1 (GC). Two weeks later, the patient returned for his sec- ond appointment. The tooth was again isolated and this time, the old amalgam filling was removed. The carious dentine was then removed with LN burs (DENTSPLY Maillefer) and an Automatrix (DENTSPLY Caulk)wasplacedaroundthetooth.Thisshouldhave been carried out at the first appointment; however, it was too tempting to try to bypass the fractured instrument first. Next, the calcium-hydroxide paste wasremovedusing10%citricacidandpassiveultra- sonic irrigation with an Irrisafe tip (Satelec). Further shaping of the canal was performed and copious cleaningwascarriedoutusing5%sodiumhypochlo- rite. The complete shaping sequence of the second appointment is shown in Table II. Fig. 3_Bypassing of the instrument with a size 08 D-Finder. Fig. 4_Working length determination. Fig. 2_The instrument was not visible through the microscope. Table II_Shaping sequence of the second appointment. Second appointment Flexile file 20 ProTaper F1 hand file Flexile file 25 ProFile 25.04 ProFile 30.04 ProTaper F1 hand file Flexile file 30 Fig. 2 Fig. 3 Fig. 4 Table II