Instrument fractures Instruments may separate (break) during<unk> , meaning a portion of the metal file used during the procedure remains inside the tooth. The file segment may be left behind if an acceptable level of cleaning and shaping has already been completed and attempting to remove the segment would risk damage to the tooth. While potentially disconcerting to the patient, having metal inside of a tooth is relatively common, such as with metal posts, amalgam fillings, gold crowns, and porcelain fused to metal crowns. The occurrence of file separation depends on the narrowness, curvature, length, calcification and number of<unk> s on the tooth being treated. Complications resulting from incompletely cleaned<unk> s, due to blockage from the separated file, can be addressed with surgical<unk> . To minimise the risk of endodontic files fracturing: * Ensure access cavity allows straight-line introduction of files into<unk> s * Create a glide path before use of larger taper NiTi files * Use rotary instruments at the manufacturer's recommended speed and torque setting * Adopt a single-use file policy to prevent overuse of files *Inspecting the file thoroughly every time before inserting it inside the<unk>  *Using ample amounts of irrigation solutions * Avoid use of rotary files in severely curved or dilacerated<unk> s Sodium hypochlorite accident A sodium hypochlorite incident is an immediate reaction of severe pain, followed by edema, haematoma and ecchymosis, as a consequence of the solution escaping the confines of the tooth and entering the periapical space. This may be caused iatrogenically by binding or excessive pressure on the irrigant syringe or it may occur if the tooth has an unusually large apical foramen. It is usually self-resolving and may take two to five weeks to fully resolve. Tooth discoloration Tooth discoloration is common following<unk> ; however, the exact causes for this are not completely understood. Failure to completely clean out the necrotic soft tissue of the pulp system may cause staining, and certain<unk><unk>  materials (e.g. gutta percha and<unk><unk>  sealer cements)<unk> so cause staining. Another possible factor is that the lack of pulp pressure in dentinal tubules once the pulp is removed leads to incorporation of dietary stains in dentin. Poor-quality<unk>  filling X-ray explanation of bad<unk><unk>  therapy Another common complication of<unk><unk>  therapy is when the entire length of the<unk><unk>  is not completely cleaned out and filled (obturated) with<unk><unk>  filling material (usually gutta percha). On the other hand, the<unk><unk>  filling material may be extruded from the apex leading to other complications. The X-ray in the right margin shows two adjacent teeth that had received bad<unk><unk>  therapy. The<unk><unk>  filling material (3, 4 and 10) does not extend to the end of the tooth<unk> s (5, 6 and 11). The dark circles at the bottom of the tooth<unk> s (7 and 8) indicated infection in the surrounding bone. Recommended<unk>  is either to redo the<unk><unk>  therapy if possible, or extract the tooth and place dental implants.
Root canal treatment
Oral medicine
Surgical lubricant
Moral treatment
Analgesic adjuvant
Dental vibration appliance
Dental antibiotic prophylaxis
Polyherbal formulation