Aim: The aim of the present case series was to present three methods of conservative instrument fragment removal.
Materials and methods: Different removal techniques were applied; ultrasonic tips, injection needles, small-size hand files and a dental operating microscope were used. Ultrasonic tips were used for the removal of stainless steel files. In one of the cases, removal occurred after loosening the fragment and activating the rinsing solution (citric acid). In another, due to the earlier separation and shortening of the removed fragment using ultrasonics, an injection needle and dental cement were employed. For nickel-titanium rotary file removal, the access to and exposure of the coronal fragment were achieved using an injection needle mounted on an endomotor, then the file was removed using cement and an injection needle.
Results: In all three cases, the instrument fragments were removed successfully. The success of removal could be influenced by the length of the broken part of the file or the lack of extrusion into the periapical tissues.
Conclusions: The file removal procedure is complicated. It requires an experienced operator, specialised equipment and knowledge of treatment and management protocols depending on the treatment case.
Keywords: fractured, instrument removal, management, root canal instruments, separated
