An X-ray of tooth #19 (previously RCT-treated) shows dilacerated roots and extrusion of gutta-percha in one direction. What is the primary visible problem on this radiograph?

Correct answer: D. Extrusion of root canal filling material beyond the apex

• A. Perforation would appear as GP in a location that breaks through the root wall laterally, not beyond the apex.
• B. While a dilacerated root is visible, the dilaceration is an anatomical finding, not necessarily a treatment problem. The active complication is the gutta-percha extrusion.
• C. Ledge formation is an intracanal complication not directly visible on the radiograph as extruded material.
• D. Correct. The primary PROBLEM visible is the extrusion of root canal filling material (gutta-percha) beyond the apex. Over-extension of GP can cause periapical inflammation, pain, and potential foreign body reaction.