Retrieval of a metallic obstruction from the root canal of a premolar using Masserann technique

Abstract

A metallic obstruction in the root canal blocks canal cleaning and shaping procedures and requires either bypassing or retrieval. Many methods have been recommended to retrieve a metallic obstruction from the root canal. This article describes the retrieval of a metallic obstruction from the root canal of a premolar using Masserann technique to facilitate endodontic retreatment. Masserann technique is said to have limited application in posteriors. However, in this case, the obstruction was successfully retrieved by employing Masserann technique which consisted of using a trephan to cut the dentine and extractor tube to retrieve the obstruction. The retrieved obstruction was found to be a separated H-file. Endodontic retreatment was completed following the detection and negotiation of an extra canal in the same tooth.

Keywords: Canal obstruction; Masserann technique; instrument removal; retreatment; separated instrument.

Figure 1

A pre-operative periapical radiograph of tooth 34 showing metallic obstruction in the middle-third of root canal and root outline suggestive of an additional root or canal

Figure 2

Apical advancement of the trephan in tooth 34 was radiographically monitored

Figure 3

Encirclement of the coronal end of the metallic obstruction by the extractor tube in tooth 34 was radiographically confirmed

Figure 4

A periapical radiograph confirmed the retrieval of the metallic obstruction from the root canal of tooth 34

Figure 5

A clinical photograph showing that the retrieved metallic obstruction from the root canal of tooth 34 was a separated H-file

Figure 6

Working length determination in tooth 34 following negotiation of the ledge and the additional canal

Figure 7

A post-operative periapical radiograph showing the obturation and access opening restoration in tooth 34