In this episode:

@olgazemliakova8515 Olga Zemlyakova demonstrates step-by-step how to safely and predictably remove broken endodontic instruments, and Herman tries it himself for the first time under her supervision. You'll see not only the "beautiful ending," but also all the real-life stages: from CT analysis to tip selection, from loosening the fragment with ultrasound to using a homemade lasso.

We examine clinical situations involving long fragments in curved root canals, when the instrument has partially protruded beyond the root. Olga demonstrates how to assemble a convenient, affordable lasso from a syringe and wire, how to use it to extract loose fragments, and why the key to success isn't a "secret tip," but an understanding of the physics of ultrasound and canal anatomy.

A separate section is a practical discussion of ultrasound:
how the tip actually moves, why tips and tips break, which movements are acceptable, and which ones are guaranteed to lead to overheating, steps, and breakage. We compare endochucks, straight steel, and titanium tips, showing which ones work best where, and the purpose of irrigation tips, orifice finder tips, and perforation area tips.

In the video:
• step-by-step assembly of a homemade lasso: syringe, needle, 0.05 mm wire, notches on the piston, securing the loop
• canal preparation: creating a microtube, checking patency, assistant's work
• ultrasound logic: linear oscillations, correct and incorrect movements, irrigation settings
• tip selection: titanium ET-25, straight steel, endochuck, irrigation tips, and orifice finder tips
• creating a safe "triangular space" and working along a small curvature
• decision-making criteria: fragment location, length, size, and fusion, root thickness, previous treatment
• when a fragment should be extracted, and when it's more reasonable to bypass, fill, and observe
• real-life work by the presenter: first attempts at fragment extraction, typical mistakes, and their analysis live
• training sets with teeth and fragments for practicing the technique outside the patient's mouth

We'll discuss this separately About psychology:
Why you shouldn't feel like a "bad doctor" if a fragment isn't extracted, why there's no tip that "gets everything," and how to learn to make informed decisions based on the prognosis rather than your own ego.

At the end of the episode, we'll tell you how you can win a training set of teeth with fragments and extraction tips by sharing your "endo tracks" and dental jokes in the comments.

If you want to understand exactly what ultrasound does in a canal and learn how to manage fragment extraction instead of relying on luck, this video is for you.

Timecodes and Titles:

00:00:28 Introduction
00:01:23 Meeting the Patient - Lentulo in a Root Canal
00:03:48 Assembling the Lasso
00:12:36 Bending the Lasso at a 45° Angle
00:13:52 Changing the Angle
00:14:45 Using the Lasso
00:16:58 Lasso Extraction Practice
00:20:28 What if the Fragment is Hitting the Canal Wall?
00:22:05 The key is to understand how ultrasound works
00:29:15 The nuances of using ultrasound
00:38:22 About two magic tips
00:44:57 How to easily trim dentin
00:47:15 Ultrasonic extraction practice
00:50:23 About fragment length
00:52:43 What extraction is based on
00:55:33 Starting the fragment movement
00:58:37 Choosing a scenario
01:01:22 The secret tip
01:05:55 Sebastian escapes
01:08:13 Practice with the second fragment
01:09:03 Determining the sequence of actions
01:11:26 Getting started
01:12:11 The hard fate of lecturers
01:13:14 Off we go Excitement
01:16:17 More about attachments
01:19:27 For those who are afraid
01:22:41 Competition - choose a track for extracting a fragment!
01:24:03 Concluding joke