Utilizing spiral computerized tomography during the removal of a fractured endodontic instrument lying beyond the apical foramen.

AIM: To present a case that used spiral computerized tomography (CT) to locate and successfully remove a fractured endodontic instrument lying beyond the apical foramen using a surgical approach.

SUMMARY: The fracture of an endodontic instrument beyond the apical foramen is rare. In this case report, after an attempt to remove a fractured instrument failed, a multi-slice spiral computerized tomography (MSCT) was used for diagnosis and treatment planning. The fractured segment was precisely located and found in the soft tissue and successfully removed by surgery. For the successful removal of a fractured endodontic instrument beyond the apical foramen, the following are necessary: (i) knowledge of the cause of fracture and how to plan treatment; (ii) determining the precise location of the fractured segment using CT; and 3) skilful operation.

KEY LEARNING POINTS: •  Fractured endodontic instruments might lie within the soft tissue. •  Computerized tomography is an effective diagnostic aid for localizing the precise position of fractured instruments.