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Explore›Clinical Mistakes›Sodium hypochlorite accident / irrigant extrusion

Sodium hypochlorite accident / irrigant extrusion

AreaEndodontics

What it is

An endodontic irrigant accident where sodium hypochlorite (NaOCl) is extruded beyond the apex or through a perforation into periapical/soft tissues, causing a chemical injury.

Why it happens

• Needle binds/wedges in the canal → pressure forces NaOCl apically • Irrigation too close to working length or in wide apical foramina (immature/open apex, resorption, over-instrumentation, loss of apical constriction) • Perforation (strip/furcal/transportation) creates an unintended exit pathway • High-pressure irrigation (rapid plunger force) rather than slow, passive delivery

The full clinical mistake entry includes

  • How to avoid it — the prevention protocol
  • The clinical tip experienced clinicians use
  • The documented reference behind the mistake
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More clinical mistakes

Skipping rubber dam isolationWrong working length (no apex locator / poor WL confirmation)Missing an extra canal (e.g., MB2)Inadequate access cavity (missed anatomy / straight-line access not achieved)Ledge formation during negotiation/shapingCanal transportation / zipping in curved canalsApical over-instrumentation (loss of apical constriction)Separated instrument not recognized early / poor management planStrip perforation in danger zonesFurcation perforation during accessInadequate irrigation protocol (volume/activation/contact time)Poor inter-appointment temporization (coronal leakage)

Dentalverse is an educational resource for dental students and dentists. This page is a study reference — it is not medical advice and does not replace clinical judgment. Always follow your institution's protocols and your supervisor's guidance.

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