Endodontics · single question
During biomechanical preparation, the patient suddenly experiences severe pain and the canal bleeds profusely. What complication is most likely?
Show answer and explanation
Correct answer: D. Sodium hypochlorite accident (NaOCl extrusion beyond apex)
Sudden severe pain + canal hemorrhage during irrigation = sodium hypochlorite (NaOCl) accident — inadvertent extrusion beyond the apex. NaOCl is highly cytotoxic; extravasation causes immediate intense burning pain, tissue necrosis, hemorrhage, and rapid swelling. Endodontic emergency. Source confirms: 'accidente de hipoclorito.'
- A. Instrument separation prevents file advancement — no sudden severe pain with canal hemorrhage.
- B. Root perforation can cause pain and bleeding but typically presents during filing, not as sudden severe pain during irrigation.
- C. Ledge formation causes difficulty advancing instruments — not sudden severe pain with canal bleeding.
- D. CORRECT. NaOCl extrusion = sudden intense pain + canal hemorrhage. Most feared irrigation complication.