Conservative retrieval of separated file with lateral perforation repair using the sandwich technique

A referred patient presented with a previously treated mandibular first molar (tooth #36) showing a separated instrument and a lateral root perforation. The perforation was caused by an incorrect attempt to bypass the fragment from the external wall. Initial attempts to bypass the fragment from the inner canal wall were unsuccessful. Therefore, a staging platform was carefully created using ET#20, followed by ET#25, to allow conservative access without unnecessary dentin sacrifice. The separated file was subsequently retrieved using a prebent ET#25 ultrasonic tip under magnification. I tried to bypass it from the inner wall but no progress, So staging plate form was done using ET#20 to avoid over cutting then ET#25 to retrieve it. Separated file retrieved using prebent ultrasonic…