Overinstrumentation: Treatment

Overinstrumentation with small file sizes often remains unnoticed. However, copious bleeding into the canal may be precipitated. Usually continuing the instrumentation with copious amounts of irrigation with sodium hypochlorite results in cessation of the the bleeding. Repeated overinstrumentation, especially with larger instrument sizes, results not only in bleeding and periapical damage, but also in destruction of the apical foramen. This in turn makes it more difficult to obtain a good apical seal. Depending on the magnitude of the damage, short or long-term calcium hydroxide treatment is recommended following overinstrumentation.