Management of Discolored Tooth with separated Instrument

Abstract

Tooth discoloration commonly occurs after trauma to tooth, which leads to pulpal injury. Trauma to the pulpal blood vessel leads to hemorrhage and releases iron from hemoglobin. The iron which is released from hemoglobin combines with hydrogen sulfide to form iron sulfide, which gives the tooth its characteristic dark appearance. Tooth discoloration can be treated by nonvital tooth bleaching, if the tooth structure is intact. A combination of hydrogen peroxide and sodium perborate reduces the discoloration of the tooth by a process of oxidation. During root canal preparation procedures, the common mishap that occurs is instrument separation inside the root canal. The fractured fragment in the root canal can hinder proper preparation of root canal space. Continuous pain or discomfort may result if it is not removed or bypassed. It is more conservative to bypass the fractured instrument, particularly in cases where access to the fragment is restricted (apical one-third of canal or beyond the canal curvature) and its removal may lead to excessive removal of dentin with associated sequelae.