Retrieval of Broken Instrument from Primary Molar and Preservation using Lesion Sterilization and Tissue Repair: A Case Report

Background: Breakage of endodontic instrument within root canal of a primary tooth is a mishap that needs to be rectified, either by retrieval or creating a circumvent around it, failing which it can become a nidus of infection causing dentoalveolar abscess and pathologic mobility. Primary tooth loss at an early age compromises function and stability of dental arch, hence, the tooth should be preserved. LSTR sterilizes the canal space, aids in rapid repair of damaged periradicular tissues and restores healthy state of tooth. Case Report: A 6-year-old girl reported with dentoalveolar abscess of mandibular deciduous left second molar with history of attempted pulpectomy aborted halfway. Radiographs revealed breakage of S1 Protaper rotary file in distobuccal canal, pathologic root resorption and furcal radiolucency. This compromised tooth was saved by manual retrieval of broken instrument and promoting healing using L.S.T.R. Purchase point adjacent to broken file was created in the canal and instrument was retrieved using H files. Triple Antibiotic Paste was used as intracanal medicament. In subsequent visits tooth was obturated with Metapex and restored with preformed stainless steel crown. Follow-up after a month, at 3, 6, 14, 18 and 24 months reported patient to be asymptomatic. Conclusion: Manual instrument retrieval with Triple Antibiotic Paste proves to be a savior of teeth with severe infections to deliver smiles in pediatric patients.