Using an Intra-Operative Navigation System to Retrieve Broken Dental Instruments

Despite popular belief, dental surgeons aren’t perfect and mistakes happen. Risk is a continuous factor for any and every dental procedure that occurs. Endodontists are no strangers to that risk. They deal with the most minuscule of spaces, having to focus on tiniest surface to conduct a surgical procedure. One of the most common surgical errors that can occur is a broken dental instrument in the mandible. Retrieving that broken dental instrument is a stressful and extremely risky procedure. The occurrence is so common that a group of researchers in Japan sought to test the accuracy and effectiveness of an intraoperative navigation system to locate and retrieve the broken dental instrument.

The case focused on a fracture of root canal instruments. It was conducted a team whose members came from Kagawa Prefectural Central Hospital and the Shimane University Faculty of Medicine. The researchers were initially exposed to common procedures for accessing foreign bodies and vital structures. These procedures included radiographs and electromagnetic devices. Although they are considered safe and accurate tools, they also neglect to provide a three-dimensional image of the area. Therefore, they sought to perform a study on the computer-aided navigation system which provided a correlative summary of collected data and the encountered anatomy structures.

In this particular case, the dental instrument broke inside the mandible during a restorative dental process of a 65-year-old Japanese female. The surgeons sought to accurately locate the broken dental instrument by using a navigation probe and an inter-occlusal splint to accurately position the mandible. The 3-D feature permitted the surgeons to approximate the anterior extent of the fragment. The following step consisted of cutting an incision at the approximated area, followed by sub-periosteal reflection. The foreign body was precisely located and removed from the apical to the tooth crown and taken out with the use of mosquito forceps.

The surgical navigation system proved to be a time-saving, stress-relieving process. Along with the use of the inter-occlusal splint, the procedure was able to retrieve a broken dental instrument in a safe manner. Additionally, there was no damage to the surrounding tissue area.

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