Removal of 5 separated instruments from ML canal of lower molar

The patient presented to the clinic with painful symptoms at tooth 4.6, diagnosed as a previously treated tooth complicated by symptomatic apical periodontitis. She was referred by her general dentist due to the difficulty in removing a separated instrument from the mesiolingual (ML) root canal. During the first session, the old restoration was removed and the coronal third of the root canal was slightly flared to gain direct visibility of the separated instrument. To our surprise, multiple separated instruments were observed at the same level within the canal. With abundant irrigation and the use of ultrasonic tips, a total of five separated instrument fragments were successfully retrieved from the ML canal. Although this outcome was initially met with enthusiasm, it…