Fractured endodontic instrument: a clinical dilemma. Retrieve, bypass or entomb?

A common clinical complication of root canal treatment is fracture of an endodontic file. The risk of treatment failure because of incomplete cleaning and shaping encourages the dentist to retrieve the fractured part. Several techniques have been offered to remove the fractured file, yet those techniques sacrifice sound dentin, which may lead to increased risk for perforations and root fractures. The aim of this article is to describe a clinical approach to accessing fractured files, depending on their location in the canal and stage of cleaning and shaping. This prudent approach may decrease complications from unnecessary dentin removal, while respecting the biological aspects of cleaning the canals.