Manajemen Teknik Klinis terhadap Instrument Patah yang Tertinggal dalam Prosedur Perawatan Saluran Akar: A Literature Review
DOI:
https://doi.org/10.54259/sehatrakyat.v5i1.6855Keywords:
Broken Files, Root Canal Treatment, Endodontics, File Retrieval Techniques, Ultrasonic ActivationAbstract
The management of fractured endodontic instruments during root canal treatment represents a significant challenge in clinical endodontic practice. Instrument fracture can hinder effective cleaning and disinfection of the root canal system, increase the risk of complications, and potentially compromise treatment outcomes. Therefore, the selection of an appropriate management technique is crucial to ensure procedural success and to maintain a favorable prognosis for the treated tooth. This literature review aims to discuss and analyze various clinical techniques used in the management of fractured endodontic instruments. The methods reviewed include non-surgical retrieval techniques, ultrasonic activation, mechanical approaches using specialized auxiliary devices, and electrochemical dissolution methods. The selected articles consist of relevant case reports, retrospective studies, and clinical investigations, with particular emphasis on the effectiveness of each technique, clinical indications, and factors influencing the success of instrument retrieval. The results of this review indicate that non-surgical techniques are the most frequently employed approaches and demonstrate high success rates, especially when combined with ultrasonic devices and magnification aids. Ultrasonic techniques have been shown to be effective in improving accessibility and visualization of fractured instruments, thereby facilitating fragment removal while minimizing dentinal damage. Electrochemical dissolution methods have also been reported to be effective in certain clinical situations; however, their success rates vary depending on the type and material composition of the fractured instrument.
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References
Algarni, Y. (2024). Fracture Incidence of New Reciprocating Nickel-Titanium (NiTi) Files: A Cross-Sectional Retrospective Study. Cureus, 16(8), e67762. doi:10.7759/cureus.67762
Aloyouni, A. A. A., Agwan, M. A. S., Almuzaini, S. S. S., Alqazlan, F. S. A., Alshumaym, A. A. A., & Alfuryah, K. A. G. (2024). Perception of Dental Interns About Intracanal Fracture of Endodontic Instruments in the Central Region of Saudi Arabia: A Cross-Sectional Study. J Pharm Bioallied Sci, 16(Suppl 4), S3890-s3894. doi:10.4103/jpbs.jpbs_1322_24
Aristiyanto, R., & Kartikaningtyas, A. T. (2021). Penatalaksanaan Bedah Periapikal Molar Pertama Maksila pada Instrumen Endodontik Patah. Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva, 10(1), 20-25.
Bordone, A., Ciaschetti, M., Perez, C., & Couvrechel, C. (2022). Guided endodontics in the management of Intracanal separated instruments: a Case Report. The Journal of Contemporary Dental Practice, 23, 853-856.
Davril, J., Hocquel, R., Vincent, M., Balthazard, R., Claude, S., Mortier, E., . . . Rahouadj, R. (2024). A first step towards the detection of damage processes in endodontic Ni-Ti alloy files, using acoustic emission. Journal of the mechanical behavior of biomedical materials, 160, 106743.
Davril, J., Hocquel, R., Vincent, M., Cappella, A., Balthazard, R., Mortier, É., . . . Rahouadj, R. (2025). Health monitoring of NiTi endodontic instruments using acoustic Emission: Spectral indicators for predictive damage detection. Journal of the mechanical behavior of biomedical materials, 107246.
de Andrade, G., Saavedra, G., Augusto, M., Leon, G., Kalalo, W., Khoman, J., . . . In, D. (2025). Awaru, BT, & Nugroho, JJ (2012). Restorasi pada gigi anterior setelah perawatan endodontik Restoration of anterior tooth after endodontic treatment. Journal of Dentomaxillofacial Science, 11 (3), 187. https://doi. org/10.15562/jdmfs. v11i3. 336. Perawatan Penyakit dan Kelainan Gigi, 103.
Dewi, P. M. K. (2024). Management of Broken Endodontic Instruments in the Apical Third of Right Central Incisor Using the Braid Technique. Interdental Jurnal Kedokteran Gigi (IJKG), 20(3), 508-514.
dos Reis-Prado, A. H., Abreu, L. G., de Arantes, L. C., dos Santos de Paula, K., de Castro Oliveira, S., Goto, J., . . . Benetti, F. (2023). Influence of sodium hypochlorite on cyclic fatigue resistance of nickel–titanium instruments: A systematic review and meta-analysis of in vitro studies. Clinical oral investigations, 27(11), 6291-6319.
Douki, N. (2022). An Effective Approach to Remove a Fractured Endodontic Instrument. Medicon Dental Sciences, 1, 12-15.
Dulundu, M., & Helvacioglu-Yigit, D. (2022). The efficiency of the BTR-pen system in removing different types of broken instruments from root canals and its effect on the fracture resistance of roots. Materials, 15(17), 5816.
Dwifulqi, H., Evelyna, A., & Ruth, I. (2025). Buku Ajar Keterampilan Prosedural Material Kedokteran Gigi: Penerbit Andi.
Eskibağlar, M., Özata, M. Y., Ocak, M. S., & Öztekin, F. (2023). Investigation of fracture prevalence of instruments used in root canal treatments at a faculty of dentistry: a prospective study. Restor Dent Endod, 48(4), e38. doi:10.5395/rde.2023.48.e38
Faizarani, M., & Prisinda, D. (2021). Pre endodontik build-up dengan teknik canal projection pada gigi insisif lateral rahang atas disertai kerusakan mahkota yang sangat luas Pre endodontic build-up with canal projection technique on maxillary lateral incisors with extensive crown damage. Jurnal Kedokteran Gigi Universitas Padjadjaran, 33(2), 101-111.
Garrocho-Rangel, A., Sánchez-Reynoso, A., Rosales-Berber, M. Á., Ruiz-Rodríguez, S., & Pozos-Guillén, A. d. J. (2021). Clinical management of intra-pulp canal broken endodontic files in primary teeth: literature review. Odovtos International Journal of Dental Sciences, 23(2), 14-18.
Gavini, G., Santos, M. d., Caldeira, C. L., Machado, M. E. d. L., Freire, L. G., Iglecias, E. F., . . . Candeiro, G. T. d. M. (2018). Nickel–titanium instruments in endodontics: a concise review of the state of the art. Brazilian oral research, 32, e67.
Karaś, B., Kotela, A., Laszczyńska, M., Majchrzak, Z., Trafalski, M., Matys, J., & Dobrzyński, M. (2025). Effect of Endodontic Irrigants on the Cyclic Fatigue Resistance of Nickel–Titanium Rotary Instruments: A Systematic Review. Materials, 18(17), 4056.
Malentacca, A., Zaccheo, F., Rupe, C., & Lajolo, C. (2023). Endodontic clinical outcome after separated instrument removal using a spinal needle technique: a retrospective study of thirty years of clinical experience. Journal of Endodontics, 49(8), 980-989.
Manu, G., Singh, S., Belim, M., Tiwari, R., Pahari, K. C., & Tiwari, H. (2019). Retrieval of Fractured Rotary Instrument from Root Canal: A Case Report. Saudi J Med, 4, 103-106.
Nariratih, D., & Dharsono, H. D. A. (2021). Penatalaksanaan non-bedah kasus previously initiated therapy gigi molar pertama maksila dengan lesi periapikal dan konfigurasi dua saluran akar mesiobukal Non-surgical management of previously initiated therapy of the maxillary first molar with periapical lesions and two mesiobuccal canals configuration. Jurnal Kedokteran Gigi Universitas Padjadjaran, 33(3), 262-271.
Orozco-Ocampo, Y. M., Escobar-Rincón, D., Jiménez-García, F. N., Álvarez-Vargas, C. A., & Jaramillo-Gil, P. X. (2024). Factors influencing NiTi endodontic file separation: A thematic review. Dental and Medical Problems, 61(2), 269-278.
Parveen, S., Hossain, M., & Uddin, M. F. (2017). Management of broken instrument by file bypass technique. Bangabandhu Sheikh Mujib Medical University Journal, 10(1), 41-43.
Pillay, M., Vorster, M., & Van der Vyver, P. J. (2020). Fracture of endodontic instruments-Part 1: Literature review on factors that influence instrument breakage. South African Dental Journal, 75(10), 553-563.
Savitha, S., Sharma, S., Kumar, V., Chawla, A., Vanamail, P., & Logani, A. (2022). Effect of body temperature on the cyclic fatigue resistance of the nickel–titanium endodontic instruments: A systematic review and meta-analysis of: in vitro: studies. Journal of Conservative Dentistry and Endodontics, 25(4), 338-346.
Silva, E., Martins, J. N., & Versiani, M. A. (2024). Advancing insights in contemporary endodontics: Proposing a multimethod approach for comprehensive evaluation of NiTi instruments. Int. Endod. J, 57, 116-118.
Sulistiyawan, H. (2024). Tinjauan Literatur Sistem Antrian Menggunakan Metode PRISMA. JIIP-Jurnal Ilmiah Ilmu Pendidikan, 7(5), 4709-4718.
Sun, Q., Lina, W., Ao, L., Jinyue, H., & Ruyue, W. (2025). Case Report: C-Shaped Canal In Mandibular Right Second Molar. International Dental Journal, 75, 104924.
Tanuri, N., Wulansari, S., & Amin, M. F. (2024). Manajemen perawatan endodontik pada molar pertama maksila dengan empat saluran akar: laporan kasus. Jurnal Kedokteran Gigi Universitas Padjadjaran, 36(4), 176-182.
Terauchi, Y., Ali, W. T., & Abielhassan, M. M. (2022). Present status and future directions: removal of fractured instruments. International Endodontic Journal, 55, 685-709.
Zhang, L., & Wang, X. (2021). Efficiency and temperature rise of file ablation by neodymium: yttrium-aluminum-perovskite laser in vitro. Journal of Endodontics, 47(6), 982-988.
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