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Endodontics · single question

During cleaning and shaping of a necrotic tooth's root canal, the patient suddenly begins bleeding and experiences significant pain beyond what's expected. What likely occurred?

  1. A sodium hypochlorite extrusion accident through the apex into periapical tissue
  2. Normal expected bleeding from canal instrumentation alone
  3. An allergic reaction to the rubber dam
  4. Anesthesia simply wearing off, with no other cause
Show answer and explanation

Correct answer: A. A sodium hypochlorite extrusion accident through the apex into periapical tissue

A sodium hypochlorite accident occurs when the irrigant is forced beyond the apical foramen into periapical tissue, producing sudden, severe pain, swelling/ecchymosis, and significant bleeding due to the chemical's tissue-damaging effect — a true endodontic emergency requiring immediate cessation of irrigation, reassurance, pain control, ice, and close follow-up.

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