An Innovative Technique for Fractured File Retrieval in a Mandibular Molar with Apical Periodontitis: A Case Report

Background: Fractured file retrieval in endodontics remains a significant clinical challenge, particularly in complex root canal anatomies. Retained instruments in infected canals reduce treatment success by 20–30%, necessitating removal despite procedural risks such as dentinal loss and perforation. Case Report: A 35-year-old female presented with symptomatic apical periodontitis in a mandibular first molar. During Root canal preparation, a rotary file fractured in the mesiobuccal canal’s apical third. Conventional retrieval methods failed, prompting the use of a novel hydraulic pressure-assisted technique combining ultrasonic vibration with controlled irrigation via an adjacent canal. The fractured file was successfully dislodged with minimal dentin loss. Four-month follow-up showed significant healing. Conclusion: This technique offers a less invasive, effective alternative to traditional retrieval methods. Its success highlights the potential for improved endodontic outcomes while preserving tooth structure. Further research is needed to assess its broader applicability.