Resumen de Efficacy of instrument removal techniques in root canal treatment: a literature review

Rómulo Guillermo López Torres, Jairo Romario Moreno Ochoa, Verónica Alejandra Salame Ortiz

• The removal of fractured instruments in root canals is a frequent challenge in endodontics, as it can compromise the cleanliness, shaping of the canal, and the prognosis of the treatment. This study aimed to evaluate, through a literature review following the PRISMA 2020 methodology, the efficacy of the main techniques for removing separated instruments in root canals during endodontic treatment. Articles published between 2018 and 2023 in the PubMed, ProQuest, and ScienceDirect databases were analyzed, selecting 14 studies that met the established inclusion criteria. The results show that the Masserann Kit, HBW ultrasonic rings, and Terauchi technique have the highest effectiveness rates, exceeding 90% in most cases, although each has associated limitations. The Masserann Kit, while effective, requires significant dentin removal, which can compromise the tooth structure. The Terauchi technique stands out for its minimally invasive approach, being especially effective for long fragments. On the other hand, the HBW ultrasonic rings offer promising results for nickel-titanium and stainless-steel fragments located in complex areas. Ultrasonic and braiding techniques, although less effective, are viable options in specific scenarios due to their accessibility and ease of use. It is concluded that the choice of the appropriate technique should be based on factors such as the length and location of the fragment, as well as the operator's skills, to optimize results and ensure clinical success in endodontic treatment