Conservative Custom Wire and Loop-Assisted Retrieval of a Long Separated Instrument Extending Beyond the Apex: A Case Report.

Separation of endodontic instruments is a recognized procedural complication that can hinder effective canal debridement and compromise treatment outcomes, making successful retrieval essential whenever feasible. A 30-year-old female presented with pain in the upper right posterior region associated with tooth 16, diagnosed as asymptomatic irreversible pulpitis with symptomatic apical periodontitis. During root canal treatment, a rotary NiTi file fractured in the mesiobuccal canal and extended beyond the apex. Owing to favorable visibility and fragment length, retrieval was attempted using a conservative combination approach involving ultrasonics for fragment exposure, Masserann trephine troughing, and a custom-made syringe-based wire loop technique. The separated instrument was successfully retrieved, after which canal preparation, obturation, and restoration were completed. This case highlights that the combined use of ultrasonics, the Masserann technique, and a custom wire loop can provide an effective, minimally invasive, and cost-effective method for retrieval of separated instruments in suitable cases.