Barbed broach

Broaches were the earliest endodontic instruments used to extirpate the pulp and enlarge the canal. A barbed broach is a short-handled endodontic instrument often used for the extirpation of the entire pulp and for the removal of necrotic debris, absorbent points, cotton pellets, and other foreign material from the root canal.

It is manufactured from a tapered, round, soft iron wire in which angle cuts are made into the surface to produce barbs. Barbed broaches are available in a variety of sizes, from triple extra-fine (XXXF) to extra-coarse (XC). Barbed broaches break easily, especially if they bind in the root canal. To avoid binding and breakage, many clinicians initiate root canal exploration and instrumentation with small reamers and files. The pulp tissue is removed, and the root canal is debrided using irrigation and aspiration. Barbed broaches are not inserted into the root canal until the canal has been enlarged throughout up to a size No. 20 or 25 reamer or file. This precaution prevents accidental binding of small and easily broken broaches.

The selection of a suitably sized broach for the removal of the pulp and gross debridement is important. A barbed broach that is too wide does not permit removal of all the pulp tissue, or it may force the pulp apically as the broach is inserted in the canal. It may also bind in the canal as it is rotated and may thereby break, or the barbs may become embedded in the dentin as the broach is withdrawn. On the other hand, if the broach is too narrow: it will not engage the pulp tissue sufficiently to allow its removal.

By comparing the size of the broach with the size of the last instrument used in the root canal or an estimated size of the image in a radiograph, one should select a barbed broach that fits loosely into the apical third of the root canal. The root canal is irrigated with a 5.2% solution of sodium hypochlorite, and the barbed broach is introduced until one notes unforced contact with root canal walls. The broach is withdrawn about 1 mm and is rotated360° to engage the pulp tissue; it is withdrawn again to remove the pulp tissue.

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