A separated file instrument or a firmly seated root post does not mean the end for your tooth. With the microscope and ultrasound, removal succeeds in 80–90 % of cases.
Sometimes foreign bodies inside the root canal block treatment — a file fragment left from an earlier root canal treatment, or a cemented root post that has to be removed in order to reach the canal.
Both situations used to be a common reason for extraction. Today, microscopic techniques and ultrasonically activated instruments allow the vast majority of fragments and posts to be removed safely — without sacrificing the tooth.
Removal is always the beginning of a further treatment — usually a root canal retreatment.
In microscopic endodontics we mainly see two types of foreign body that need to be removed.
Root canal files made of steel or nickel-titanium can fracture during treatment — usually in the apical third. As long as the fragment does not seal the canal, retreatment remains technically impossible until it has been removed.
Fibre, titanium or cast posts from earlier core build-ups. They have to be removed to gain access to the root canal — for retreatment, or when a root fracture underneath is suspected.
Removal is millimetre-precision work. We combine the microscope, ultrasound and specialised micro-instruments.
Without magnification you are working blind. Under the microscope we see the fragment, how it is seated and all the structures around it.
Fine ultrasonically activated tips loosen fragments and posts through high-frequency vibration — gently for the tooth structure.
Masseran trepan burs, the IRS system, Cancellier adapters, loop systems — the right micro-instrument for every post and every fragment.
In complex cases the fragment is localised in 3D — we know exactly where it lies before treatment begins.
We remove only as much tooth structure as necessary — so the tooth remains stable after treatment.
Treatment continues immediately after removal — usually retreatment or, if needed, apicoectomy.
Radiographs / CBCT for localisation. Assessment of the position, depth and type of foreign body.
We discuss the chances of success and the risks openly — no false promises.
Pain-free treatment in a dry, bacteria-free working field.
Direct visual contact with the foreign body at 25× magnification.
Vibrations release the bond between the foreign body and the tooth structure.
Depending on the situation: loop, trepan bur, Cancellier adapter or forceps.
Microscopic and radiographic check — we confirm complete removal.
Direct transition into retreatment or a planned follow-up session.
Removal of separated instruments carried out under the microscope.
Fibre, titanium and cast posts can be removed in over 90% of cases.
Usually one session of 60–90 minutes — often moving straight on to retreatment.
The removal of fragments or posts is a specialised treatment that is normally charged as a private service and invoiced accordingly.
Removal is usually the first step of a retreatment — we discuss the total cost transparently before treatment begins.
The questions patients ask most often — answered directly.
With microscopic removal using ultrasound 80–90 %, depending on the position, size and type of the fragment. Separated instruments in a straight canal are usually straightforward to remove; in a strongly curved apical third the procedure is more demanding.
Most root posts — fibre, titanium and cast — can be removed with the microscope and ultrasound. Very long or tightly wedged posts take more effort, but removal succeeds in over 90% of cases without loss of the tooth.
We assess the chances of success beforehand using CBCT. If removal appears too risky or impossible, alternative strategies are available:
Under local anaesthesia the treatment is pain-free. Slight pressure sensitivity afterwards is normal and settles quickly.
Typically 60–90 minutes. In most cases one session is enough, and we start the retreatment directly afterwards.
Costs are usually between 250 and 600 euros for one fragment or one post, depending on complexity. We draw up a transparent cost estimate before treatment begins.
No — you can book an appointment directly. Please bring any recent radiographs or CBCT scans with you if you have them.
Removal is usually the first step — we continue treatment directly.
Removal is usually followed by retreatment.
Learn more SurgeryWhen removal is not possible — the surgical route.
Learn more DiagnosticsPrecise localisation of the foreign body before treatment.
Learn more RepairIf a perforation occurs during removal — repaired immediately.
Learn morePlease bring recent radiographs with you. We will discuss the chances of success honestly.
