Management of a Curved Maxillary Second Molar with Limited Mouth Opening and Successful Bypass of a Separated Instrument: A Case Report

Abstract Managing root canal treatment in maxillary second molars presents significant clinical challenges due to limited access, reduced mouth opening, complex anatomy, and severe canal curvature. These difficulties increase the risk of procedural errors such as instrument separation. This case report describes the successful endodontic management of a maxillary second molar with severely curved mesial and distal canals, limited working space, and a separated instrument within the distal canal. The treatment strategy included the use of flexible nickel-titanium files, pre-bending of hand files prior to rotary instrumentation to reduce the required straight-line access, and successful bypass of the fractured instrument. The case highlights practical clinical techniques that enhance safety and predictability in complex endodontic cases. Introduction Maxillary second molars are…