Success Rates for Management of Separated Instruments

Study Overview
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Brief Summary
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The study compares the prognosis of cases of Separated Instruments in Canals With Type II Vertucci's Classification treated with conservative approach

Detailed Description
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Teeth with Type II Vertucci root canal configuration are having more incidence of instruments separation due the presence of an S-type (Double curve). The aim of this study is to compare the outcome of minimally invasive approach (MIA), retaining the separated in one root canal, cleaning and shaping of portals of entry of the two canals and portal of exit of both canals through the other patent canal, in comparison to the outcome of retrieval of the broken instrument by ultrasonics retrieval techniques (URT)

Official Title
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Success Rates for Management of Separated Instruments in Canals With Type II Vertucci's Classification: Prospective Clinical Study

Conditions
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Teeth, Endodontically-Treated

Intervention / Treatment
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* Procedure: Endodontic retreatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Presence of separated instrument in a root with a Vertucci's type II configuration (the level of the SI was evaluated using CBCT scans) Age range 35-55 years Teeth having a baseline periapical lesion (PAI score ≥2) in the affected root Exclusion Criteria: • Patients who refused to undergo radiographic follow-up. Pregnant females. Patients suffered from a systemic disease. Teeth with lesions connected to adjacent teeth. Teeth with root fractures or perforations. Teeth with lesion communicating with the alveolar crest. patients with generalized chronic periodontitis or teeth that need periodontal surgery prior to coronal restorations due to marginal deficiency teeth with damaged or resorbed peri- apex teeth that were treated with a fiber post and teeth with canal curvature more than 25 degrees

Ages Eligible for Study
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Minimum Age: 33 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: conservative treatment<br>The patent canal is retreated, no attempt to deal with the separated instrument | Procedure: Endodontic retreatment<br>* retreatment of the patent root canal only without attempt to retrieve the separated instrument<br>|
| Active Comparator: traditional<br>All canals are retreated with attempts to retrieve the broken file | Procedure: Endodontic retreatment<br>* retreatment of the patent root canal only without attempt to retrieve the separated instrument<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| monitoring of periapical index | The peri-radicular condition was evaluated using the Periapical Index (PAI) created by Ørstavik et al. (1986). The PAI includes five grades represented on an ordinal scale as follows: (1) normal periapical structures; (2) small changes in the periapical bone or bone structure; (3) changes in the periapical bone structure with mineral loss, characteristic of apical periodontitis; (4) demineralization of the periapical bone within a well-defined radiolucent area; and (5) demineralization of the periapical bone with exacerbations and expansion in bone structure. | 2 years |