Question

The tip of a spreader is broken in the apical third of a root of a maxillary central incisor during lateral condensation. Treatment of choice is to

A. remove the gutta-percha using solvents and remove the broken tip using broaches.
B. remove the gutta-percha and, if the broken tip cannot be removed, place EDTA to soften the dentin to help create a bypass.
C. complete obturation and surgically remove the apical segment of the root that contains the tip and burnish the apical gutta-percha.
D. complete obturation, surgically remove the apex and place a retrograde filling.
E. complete obturation, do no further treatment and observe.

Answer 1

If a spreader tip breaks in the apical third of a root, the decision to complete obturation and leave the tip in place or remove it surgically depends on factors like canal obstruction and periapical pathology. The aim is to ensure a proper seal and consider the tooth's integrity and potential for healing.

Step-by-step explanation:

When the tip of a spreader breaks in the apical third of a root during lateral condensation, treatment options are evaluated based on the clinical situation. If the broken instrument does not obstruct the canal and no periapical pathology exists, it may be possible to complete obturation, leaving the fragment in place and sealing the canal. However, if the presence of the fragment will compromise the seal or if periapical infection is a concern, surgical intervention to remove the apical segment containing the tip might be necessary. The apical surgery would involve removing the segment of root with the fragment and burnishing the apical gutta-percha to create a proper seal.

Each case should be evaluated individually, considering factors such as the likelihood of retrieving the fragment without damaging the tooth structure and the potential for successful healing post-surgery. In some cases, where the fragment is well-contained, asymptomatic, and not compromising the seal, it may be preferable to complete obturation, do no further treatment, and observe the situation over time.