Management of fractured endodontic instruments

  • Theodor Lambrianidis
Springer; 2018 price £139.99 pp. 283 ISBN: 9783319606507 | ISBN: 978-3-3196-0650-7

This 279-page book was written with the aim of providing the reader with a greater understanding of the factors affecting instrument fractures and provides an insight into the subsequent operative management options.

With its heavy focus on a specialised segment of endodontic practice, this book is suitable for endodontists or dentists with a special interest in endodontics. However, with several chapters on analysing the causes of instrument separation, it clearly outlines practical steps that can be undertaken to minimise instrument failure and therefore wholeheartedly justifies its relevance to the wider dental audience.

The introduction looks at the prevalence of endodontic instrument fractures focusing on the different types of foreign objects that may be found separated in the root canal. The first chapter builds on this and includes several comprehensive tables summarising the different studies analysing fracture incidence of endodontic instruments. The breakdown of these studies by system used, operator type and size of study helps the reader easily contextualise the available research on this topic. Of note, the column analysing fracture incidence is helpful in educating the reader regarding their individual theoretical risk of instrument separation and therefore could be instrumental in achieving comprehensive patient consent when undertaking endodontic treatment.

The next two chapters analyse the factors and mechanisms of instrument failure. This includes operator, anatomical, instrument and technique related factors. These chapters are well illustrated and contain numerous clinically relevant examples of radiographs and photographs.

The remaining bulk of this book delves into the different therapeutic options for management of instrument fractures. It is clearly segmented to analyse both surgical and non-surgical options and does not shy away from providing clear information about the risks associated with these treatment modalities.

In summary, this is a well written book that analyses the latest literature regarding the cause and management of fractured endodontic instruments. The book attempts to capture clinical expertise from various renowned sources and actively seeks focus on an international audience. While some of the nuances such as reuse of files are of no direct relevance to a UK audience, the topic is only briefly discussed. The book is full of visual aids to assist in explaining the underlying concepts; of particular mention are the numerous tables that can act as a 'treatment flow chart' for different types of instrument fractures in both paediatric and adult dentition.