Bypass de instrumento endodôntico fraturado: relato de caso

Abstract

Introduction: Even with all technological evolution of these instruments, with the development of nickel-titanium alloy (NiTi) files and mechanized systems, fractures can occur during chemical/mechanical preparation. There are three most commonly applied approaches

to resolve this complication: attempting to remove the instrument with ultrasound, attempting to bypass it, or obturating the segment. Objective: To report a case of bypass technique in fractured instrument in the root canal. Case description: A 47-year-old Brazilian female patient, without associated systemic conditions, was referred to the Endodontics Specialization Course of Faculdade Arnaldo, Belo Horizonte, Minas Gerais, Brazil, for resolution of an instrument fracture in the mesial vestibular canal of the right maxillary first molar (16). Treatment was chosen by the bypass technique, which involved the following steps: anesthesia, opening, use of #08 C-pilot file to bypass the fractured instrument, odontometry, regressive scaling from the k#20 file, disinfection with 5% sodium hypochlorite, medication with calcium hydroxide for 21 days, agitation of the irrigating substance and obturation of the root canals. Conclusion: Instrument bypass is a conservative, effective technique and an adequate solution in cases of endodontic file fracture within root canals. This technique aims to preserve as much of the original tooth structure as possible, avoiding more invasive procedures.