Background: Fracture of endodontic instruments during root canal treatment poses a significant challenge. Retrieval of the fractured fragment is crucial to prevent infection, ensure complete canal filling, and maintain tooth structure.

Case Presentation: A 36-year-old female patient presented with a fractured NiTi rotary instrument in the mesial root canal of tooth #46 (mandibular right first molar). The fragment was located 2mm from the apex. Intervention: Under dental operating microscope, a combination of ultrasonic instrumentation (ProUltra) and canal exploration with a retrieval device (Masserann kit) was employed. The fractured instrument was successfully retrieved, and the canal was subsequently filled with gutta-percha using bioceramic sealer

Results: Post-operative radiographs confirmed complete canal filling and absence of periapical pathology. The patient remained asymptomatic at 4-month follow-up. Conclusion: This case highlights the importance of meticulous technique, specialized instrumentation, and microscopic visualization in successful retrieval of fractured endodontic instruments, ensuring optimal treatment outcomes.

Keywords: Fractured instrument retrieval, Endodontic instrument separation, NiTi rotary instrument, Ultrasonic instrumentation, Dental operating microscope