Impact of anatomical and clinical variables on the success of endodontic instrument fragment retrieval.

PURPOSE: Separation of instrument fragments can impede the progress of endodontic treatment, and effective management of this complication is crucial for treatment success. This study examined the factors that impact the success of retrieval of separated instrument fragments by postgraduate endodontic residents.

METHODS

A retrospective analysis was conducted on a total of 224 teeth associated with instrument fragment separation that were managed by postgraduate residents specializing in endodontics between January 2020 and March 2024. Data were extracted from patient records, periapical radiographs, and clinical notes. Chi-squared test and t-test were employed to identify factors significantly influencing retrieval success. Associations between successful retrieval and variables were assessed using binary logistic regression models.

RESULTS

Fragment retrieval was successful in 32% of the examined cases. Retrieval was more likely to be successful for anterior teeth than for premolars and molars (P = 0.003). Fragment separation in the coronal third of the canal had a higher retrieval success rate (P < 0.001). Longer separated fragments were also associated with increased retrieval success (t = 3.035, P = 0.003).

CONCLUSION

The study revealed that factors critically influencing the successful retrieval of separated instrument fragments included the tooth type, the level of separation within the canal, and the fragment length. These findings highlight the importance of careful case selection in order to optimize management outcomes.