Endodontic file use for extraction of root tips

The endodontic file use for extraction of a root tip

Endodontic file use for the extraction of a separated root tip is a great trick to have when a small section of a tooth root breaks off and seems unretreivable without a lot of sweat or bone removal.

Root tip removal via an endodontic file technique
Root tip removal via an endodontic file technique

How do you use the endodontic file to get a root tip?

It is not that uncommon for a root tip to break during a tooth extraction. So, how are you doing to retrieve the root tip? It’s very simple to do but you will likely need magnification and illumination. Most root tips are already loose by the time they break but there is simply no access to grab them. What the file allows for is a handle to remove the root tip.

  1. Since we are using an endodontic file please use some form of patient protection. I prefer to have an isolite for extractions thus I already have protection in the case the file slips from my fingers. Other forms of throat protection are fine as well and some will even use a rubber dam.
  2. A Hedstrom #25 seems to be the ideal go to file for most cases but other sizes and files will also work.
  3. Insert the file into the canal system. This is where you are going to need loupes and magnification. Twist the file into the canal until it is wedged.
  4. Remove the file and the root tip will come with. Since the root tips should be loose at this point of the extraction this is very easy to do.

Is there any research on the root tip removal via an endodontic file technique?

There is some but there is not much to really “research” other than present some cases studies. Chen in 2016 shows why the #25 Hedstrom file is the one we prefer to use as it has the greatest pull out strength. Ali 2017 shows a case report online giving the basics.

Overall, it is simply a nice little oral surgery trick to have at your disposal. If you ever try it you will see it almost seems too easy.

Endodontic file use for extraction of a root tip
The endodontic file use for extraction of a root tip