Broken instrument retrieval from root canal of tooth using finely designed innovative instrument fragment removal screw mechanism (IFRS) tool.

Abstract

The success of any root canal treatment depends on the results of the cleaning and shaping process. However, during this process, the instruments (endodontic K-files) used to carry out this procedure, are more prone to fracture inside the tiny canals. This can lead to endodontic treatment failure. The incidence of broken files (instrument) is 0.25% for hand instruments and 1.68%-2.4% for rotary instruments. There are several factors considered in managing these cases, which includes visibility, level of broken file inside the root canal, and the structure of the remaining tooth tissue. Furthermore, this treatment often requires special assistance because of the risk of complications such as pushing the file apically, extruding fragments outside the apex, risk of tooth fracture due to compromised radicular dentin, root perforation, and formation of a ledge. Different methods for instrument retrieval are available that includes use of trephine burs. The trephine burs are used to trough the fractured instrument periphery in the preparation step followed by removal attempts using ultrasonics or special files. This will create a tiny space on one side of the fractured instrument in the preparation step followed by removal. At present, different types of innovative tools for file retrieval are available like Masserann kit, ultrasonic, microtube, and plier devices, along with the assistance of a microscope to facilitate visibility and minimize the removal of radicular dentin structure. All the above-mentioned tools and methods involve removal of radicular dentin to some extent and use of loupes and magnifying devices. In order to overcome these problems and to ease retrieval of fractured endodontic instrument without sacrificing the radicular dentin, we planned an innovative tool design, the IFRS tool. This IFRS tool will be very finely designed considering all the dimensions and structure of root canal of tooth. While designing this IFRS tool, all the variations inside the root canal were considered. It will be very useful in retrieval of broken instrument.

Specification

Description:Components -
1. Hollow tube - One large hollow metallic tube consisting of two semicircular tubes apart from a elastic cube and a screw.
2. Semicircular tube - Two semicircular tubes will be there inside the hollow tube. They will act in grasping motion.
3. Screw - One screw will be used to tighten the semicircular tubes once they grasp the broken part.
4. Elastic cube - Cube shaped block will be used to hold the two semicircular tubes.

Detailed Description
Firstly, in this IFRS tool we will take one hollow tube of diameter approximately 2-3mm and length of 5-6cm. In this hollow tube, we will attach one screw and two semicircular tubes. This IFRS tool will work on locking mechanism. On activation of the IFRS tool, these two semicircular tubes will open up and will approximate at 10-20 degrees to each other. For closing the instrument, screw will be moved inside the tube which will help in closing the two semicircular tubes. Closing diameter of the two semicircular tubes will be 0.5-0.8mm and diameter of screw will be 1-1.5mm. Length of semicircular tubes and screw should be 5-6cm. For holding two semicircular tubes in large hollow tube, a cube having dimensions of 1-1.5mm (length, width, and height) will be placed. This cube will be made up of elastic material which will help in proper closing and opening of the IFRS tool. When the semicircular tubes will be placed inside the canal, then the screw will be tightened which will help in holding the broken part of instrument inside the root canal. After tightening of the screw, it will firmly grip the separated instrument fragment. Thus, finally the fractured instrument will be retrieved.

Mechanism of action - On activation of IFRS tool, the two semicircular tubes will orient each other at some angle which will act like a mouth (holder) of the instrument. At this stage, the IFRS tool should be properly placed inside the canal as it will grasp the broken part of instrument or file. We can confirm the proper positioning of the IFRS tool by taking radiovisiography (RVG). After confirming the proper positioning, we have to tighten the screw. This will help in holding the broken fragment of the instrument in proper position which will then be confirmed with RVG. Once its confirmed, then we can activate the IFRS tool and pull the broken part of instrument out from the canal.
, Claims:1. This IFRS tool will help in retrieval of broken instrument from the root canal of tooth. This IFRS tool is precisely designed with specific dimensions. Also, due to increase refinement of the innovative tool, there will be no need for trephination or any loss of tooth structure.
2. Finely designed IFRS tool with very less dimensions.
3. Components including hollow tube, two semicircular tubes, screw and elastic cube.
4. Easy to use because of simple mechanism.
5. Easy removal of broken fragment.

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