Re-RCT going on. Scared after seeing new xray. Long term damage expected?


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Pls see attached xrays. The first xray was from the first RCT - it was taken 2 months after filling metapex (metapex was still filled inside). I still had a lot of pain but that first dentist was doing nothing about it and said it's just a wound and wanted to seal it. Then I went to a different dentist (an endodontist) who yesterday checked with a microscope and said he found no fracture/extra canal/perforation, and that the pain must be due to the fact that the lingual canal (the longest one) was not filled all the way to the apex). So he reopened the canals and instrumented them to reach the apex. I had great pain during the process so he gave me a shot of local anesthesia. Aftre he was done, he then inserted the files and took the xray. The second xray is the one he took. I was horrified to see the files extending way way beyond the apex. Were those files inserted into the bone or is that the empty sinus space or what? Is that why I was having so much pain during his treatment? Will I get any long term damage from this? Any advice on what should be done now? He said he irrigated the canals but has not filled any medicine inside the canals (just cotton, i think he said?) and put a temp filling and has told me to come back on March 8 to irrigate the canals again. He realized he has overextended but tried to justify it saying that will drain out any infection. i doubt it as the overextension is so much. It's paining today quite a lot. Pls advise if I will get any long term damage from this? Pls advise on what should be done now.
 

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MattKW

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This is an endodontist? Where are you in the world? Why didn't he give you LA at the start?
Instruments going past the apices will almost certainly still be in bone, not in the sinus.
Those instruments are too far through the apices to be able to calculate the true working length. Do you have any other Xrays that he took?
If he instrumented and irrigated based only on those Xrays, then it is likely that some short-term damage has been caused in the bone, and all should heal.
 
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No other xrays were taken that day. Approximately how long would it take for the bone to heal in this case? My bigger concern is that, after taking this xray and pulling out the files, he may have left some drill/file tip behind. I say this because I can see some small perpendicular metal (?) piece sticking out perpendicular to the file. Pls see the same xray below in which I have now put a red circle. What is that? It was not there previously. It looks like it could be some broken drill bit or file tip ? I don't know whether it's from this endodontist's drilling or if it's a broken tip left from the first dentist's work which has now gotten pushed out by this endodontist's drilling. Either way, it would not have gotten pulled out along with the file, right? And is that particular broken tip in the bone or the sinus? If it's a broken tip and remains there permanently (embedded in the bone or sinus), then will it cause long term problems/infection/inflammation down the road? Pls advise what to do now.
 

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I will have to search for another endodontist (which will take time), but meanwhile I got another xray taken at another regular dental clinic, as I was worried (due to the previous xray attached in my last message) that some broken drill bit or file tip had gotten left behind in the bone above the first maxillary molar which could cause long term problems/infection/inflammation down the road. Pls check this new (today's) attached xray and let me know if anything is left behind? First xray is the previous one showing the red circled area, and second xray is today's.
 

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