Title

Fractured Endodontic Instrument has No Effect On Healing

Clinical Question

Does a retained fractured endodontic instrument affect the healing of a periapical lesion?

Clinical Bottom Line

There is no significant difference in healing between teeth in which a fractured instrument is retained and teeth in which no fragmentation and retention occurs. (See Comments on the CAT below)

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
20416418	Panitvisai /2010	199 patients	Meta-analysis of 2 case-control studies
Key results	A retained instrument fragment did not significantly influence healing. The healing rate was 91% when a retained instrument fragment was present (80.7% when a periapical lesion was present; 92.4% when no lesion was present initially.

Evidence Search

"Root Canal Preparation"[Mesh] AND ("Equipment Failure"[Mesh] OR "Dental Instruments/adverse effects"[Mesh] OR retained instrument)

Comments on
The Evidence

The authors performed a systematic review of the published literature. Two case-control studies were identified and included, covering 199 endodontic cases. Meta-analysis was performed.

Applicability

This evidence should be taken into account when considering the prognosis of a tooth with a retained endodontic instrument fragment.

Specialty

(Endodontics) (General Dentistry)

Keywords

Retained endodontic instrument fragment

ID#

875

Date of submission

04/28/2011

E-mail

browned@livemail.uthscsa.edu

Author

Eric Brown

Co-author(s)

Co-author(s) e-mail

Faculty mentor

S. Thomas Deahl, II, DMD, PhD

Faculty mentor e-mail

DEAHL@uthscsa.edu

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

by Brandon Pitcher & Nancy Quach (San Antonio, TX) on 10/03/2014
A PubMed search was conducted (Sept 2014) and a more recent article was found on the subject. McGuigan et al (2013) PMID 23518972 comes to the same conclusion that separated files do not significantly affect healing of periodical lesions.