Root canal blockage management: Ledges, bricks and broken tips

Occasionally, instruments cannot be advanced to full working length during root canal instrumentation. This may be due to calcifications, ledge formation, or canal blockage by foreign objects such as separated instruments. All these clinical scenarios and accidents might affect treatment outcomes if the canals below the blockages are infected. Bypassing calcifications, ledges and broken files will re-establish the previously blocked canal pathway enabling full-length disinfection procedures to take place. This lecture is designed to highlight the instruments, techniques and skills required for a successful bypassing procedure.

Learning objectives:

• Understand the problem of calcified canals.
• Understand the mechanism of ledge formation and file breakage.
• Understand how to manage calcified canals.
• Understand how to bypass and eliminate ledges.
• Understand how to bypass and remove broken files.
• Take away tips and tricks to use in the everyday practice.