![]() Influence of Canal Curvature Angle and Radius on File Breakage Such handling practices would provide a realistic picture of the actual canal anatomy, eliminating file separations.Ĭorrelation between root canal anatomy and file breakageĪ variety of factors play the role of an adjunct when it comes to the breakage of files within the confines of the root canal. Before performing on the patient, proper preclinical training and file handling should be mastered. Excessive force should also be avoided when handling files, and the manufacturer's specifications should be followed. Instruments should never be put into dry or lubricated canals. Before depositing files into the canal, they must be meticulously evaluated to ensure that their cutting blades are appropriately aligned. For proper instrument and usage practices, several guidelines have been proposed. The operator's expertise and training efficiency are exceptionally crucial in clinical endodontics. ![]() The operator's aptitude and ability are one of them. It is essential to mention a multitude of other factors that shape the instrument separation. The time it takes for a file to fail falls dramatically as the rotational speed increases. The instrument's rotational speed has also been found to contribute to cycle fatigue. ![]() According to Pruett et al., the instrument size, radius, and angle of curvature play a role in cyclic fatigue. Torsional stress has been found in 55.7% of the cracked files studied by Sattapan et al., while cyclic fatigue was found in 44.3%. This occurs when the instrument's tip is jammed in the canal while the shaft is in motion or continues to rotate. On the contrary, torsional stress is the shear stress induced on a transverse cross-section by twisting an instrument's shaft. When the instrument does not bind in the canal but rotates freely in a curve while subjected to repeated tension and compression cycles, the structure disintegrates and eventually fractures. Overuse, or when instruments are used to their maximum limits of cycle fatigue and torsional stress, is the most prevalent cause of instrument separation or breakage. Furthermore, these mishaps are linked to a lack of professional knowledge of the technique, excessive instrument use, insufficient use, and the amount of instrument sterilization undergone by the instrument. ![]() It is also one of the most common reasons for tool fracture. The root canal system's anatomical diversity is one of the most challenging hurdles to conquer during endodontic treatment. The incidences of fracture of rotary nickel-titanium (NiTi) files and conventional hand files are also shed light upon in this article, which gives a brief insight into the prime factors and the possible causes of the separation of instruments when they are mishandled wrongly within the root canal systems. The dilemma of whether the separated instrument should be left inside the canal or bypassed is always a junction where the clinician needs to rely on his clinical skills and expertise to retrieve or leave the fragment in situ. Negotiation of broken instruments when they get fractured in extremely thin and highly curved root canals becomes a challenge. A thorough pre-evaluation of each case is a mandatory procedure that should not be disregarded by the clinicians. Such errors reduce the effectiveness of removing the clogged debris from the canal further reducing the healing of the periapical lesions when fractured fragments are left in the canal. However, this situation of instrument separation and file breakage becomes a problematic incident for the operator to ameliorate. Ledging, zipping, perforation, and apical transportation of the canal along with instrument separation are some of the most commonly encountered endodontic errors encountered in routine practice. The occurrence of procedural iatrogenic errors is inevitable during the biomechanical root canal preparation procedures. With the increasing patient demands for faster treatments to be made available to them, it becomes a challenging task for the operator to satisfy the demands of the patient at the correct time as well as deliver the highest quality of service. Instrument separation happens all the time, not just with students and general practitioners, but even with professional and seasoned clinicians, despite taking all precautions. Instrument separation in the root canal is one of the most common procedural mistakes encountered during endodontic therapy. A clinician needs to recognize the underlying biological and mechanical guidelines of instrumentation in today's era of current competitive endodontics.
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