Many doctors know the frustration and difficulties of removing fractured instruments from root canals. It has been a long known issue and the techniques and systems that were available didn’t really solve the problem. Dennis Köhrer, the inventor and engineer of the EndoCowboy® also faced this problem in his everyday business as a specialist in endodontics. In his referral-based endodontic practice he has seen several cases with broken files. Removing those fractured instruments has always been a time consuming and unpredictable task. A root canal that is blocked by an instrument is almost impossible to rinse, clean and fill properly. His engineering background lead to a constant strive of finding the best and reliable way of retrieving instruments from root canals in a secure, fast and predictable way. Ultrasonic activation helps to loosen the file, but if the fragment is to long to be flushed out with the rinsing liquid and the file is stuck deeply in the canal, with a long contact to the canal wall, it becomes difficult to remove. The lasso- or loop-technique has been a good approach, but alway came with serious handling problems. More than a year of constant testing with several prototypes lead to the solution:
The new EndoCowboy® is an endodontic instrument, that allows you to salvage fractured files in a secure and predictable way. You will see. after a short learning curve, retrieving broken instruments with the EndoCowboy® becomes a manageable and most of all deeply satisfying mission. Surprise your referring doctors and enjoy the applause.
The EndoCowboy® is a Micro-Lasso tool that can be precisely adjusted and makes it possible to grab files even deep down in the canal through a minimal invasive access. A tip of only 0.4 mm with a standard wire of 0.1 mm helps you respect the natural anatomy while removing the fractured instrument.
With a small ultrasonic tip a small circular space needs to be created around the upper part of the fractured instrument. Than ultrasonics are used to pre-loosen the broken instrument. When you can see a slight “dancing movement” of the instrument, the EndoCowboy® is being applied. The tip of the EndoCowboy® can be bent as needed for best access. The micro loop is to be placed around the upper tip of the instrument and than to be closed by your Assistent. Now the instrument is hold tide in the loop and it can be removed. As a result of many tests with differently designed prototypes we found out, that the design, were the Assistent closes the loop over the adjusting wheel at the back of the EndoCowboy® is the best and precise way. With this design the doctor can fully concentrate on the right placement of the loop and doesn’t have to move to close the loop. In addition the loop tension is constant and does not need to be held by the doctor. The accurately adjustable mechanism guarantees a perfect feedback of the loop-tension. With a gentle movement similar to the movement of extracting a tooth, the file can be easily removed from the root canal. Other than other loop systems, the EndoCowboy® is designed to remove even ingrained instruments. The specially designed stainless steel wire shows high tear resistance.
Using the EndoCowboy® will make you the expert in file retrieval. In the past a tooth with a broken file was often sooner or later extracted. The difficulty of cleaning a blocked root canal system leads to a poor longterm success rate. A successful retrieval of a blocking instrument lets you treat the root canal system like nothing happened.
In the past a file fracture during a root canal treatment has been a nightmare for every dentist. It often means replanning and overthinking the whole therapy strategy. Should I try to work around the file? Should I still fill the tooth and finish the RCT? Can I still use this tooth in my further prosthetic planning? etc.
