tooth to be treated is then isolated using a rubber dam, which prevents saliva entering the tooth during treatment and protects the airway from the fine files and strong chemicals used. The root canal treatment procedure is often carried out over single or multiple appointments. Root canal treatment involves: Removing the damaged and infected pulp Shaping the entire root canal system Cleaning and disinfecting the entire root canal system Filling and sealing the root canal system Placing a direct restoration such as composite filling or indirect restoration such as a crown Instrument fractures are common procedural mishaps in root canal treatment. It is essential to prevent instrument fractures. The success of removing of broken instrument depends on the location, direction and type of instrument. A sodium hypochlorite accident can result in long-term functional and aesthetic complications. Extrusion of sodium hypochlorite irrigating solution during a root canal procedure can cause a severe inflammatory reaction and tissue damage. Treatment is provided based on the severity of the injury. Tooth discolouration as a result of root canal treatment can occur if the pulpal tissue remnants are not completely removed or if a root canal sealer material containing silver is used. Periradicular surgery Periradicular surgeries involve the root surface. These include apicoectomy (removal of a root end), root resection (removal of an entire root), repair of an injured root due to perforation or resorption, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures. Apicoectomy An apicoectomy is a surgical procedure through which the apex of a root is resected, and a root-end filling is placed, preventing bacterial leakage into the root canal system from the periradicular tissues. A microsurgical technique is used to carry out apicectomy, which improves post-operative healing. An apicoectomy can be carried out when a previous root canal treatment fails, and re-root canal treatment is not possible. This may be as a result of anatomical features, such as root dilaceration, which can compromise the completion of cleaning and obturating the root canal system. Procedural errors including ledges or perforations, may also be indications for an apicectomy. Local anaesthetic is utilised to achieve anaesthesia as well as haemostasis for improved visualisation. A flap in the gum is designed, and then raised to allow for exposure of the periapical lesion. Bone removal (osteotomy) is carried out to enable access to root apex, and