Management of Sodium Hypochlorite Accidents : A Trio Series of Case Reports
DOI:
https://doi.org/10.24191/cos.v13i1.7313Keywords:
root canal treatment, root canal irrigation, sodium hypochlorite, mishapsAbstract
Sodium hypochlorite (NaOCl) is the most often used solution in root canal treatments due to its inexpensive cost and highly efficient antibacterial activity against diseased root canal microorganisms. Nonetheless, this solution can produce difficulties due to its cytotoxic properties. When this solution is injected into neighbouring tissues, the patient typically experiences excruciating pain, and an immediate therapy is required to prevent long-term complications. This article covers the clinical characteristics of three individuals who sustained unintentional NaOCl extrusion following endodontic treatment of variable severity and different therapies. In addition, it describes the long-term neurologic impairments that this type of accident may produce and suggests a treatment strategy for such cases.
References
Al-Daafas, A., & Al-Nazhan, S. (2007). Histological evaluation of contaminated furcal perforation in dogs’ teeth repaired by MTA with or without internal matrix. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 103(3), e92–e99.
Becker, G. L., Cohen, S., & Borer, R. (1974a). The sequelae of accidentally injecting sodium hypochlorite beyond the root apex: report of a case. Oral Surgery, Oral Medicine, Oral Pathology, 38(4), 633–638.
Becker, G. L., Cohen, S., & Borer, R. (1974b). The sequelae of accidentally injecting sodium hypochlorite beyond the root apex: report of a case. Oral Surgery, Oral Medicine, Oral Pathology, 38(4), 633–638.
Ehrich, D. G., Brian Jr, J. D., & Walker, W. A. (1993). Sodium hypochlorite accident: inadvertent injection into the maxillary sinus. Journal of Endodontics, 19(4), 180–182.
Goerig, A. C., Michelich, R. J., & Schultz, H. H. (1982). Instrumentation of root canals in molar using the step-down technique. Journal of Endodontics, 8(12), 550–554.
Gorni, F. G., Andreano, A., Ambrogi, F., Brambilla, E., & Gagliani, M. (2016). Patient and clinical characteristics associated with primary healing of iatrogenic perforations after root canal treatment: results of a long-term Italian study. Journal of Endodontics, 42(2), 211–215.
Guivarc’h, M., Ordioni, U., Ahmed, H. M. A., Cohen, S., Catherine, J.-H., & Bukiet, F. (2017a). Sodium hypochlorite accident: a systematic review. Journal of Endodontics, 43(1), 16–24.
Guivarc’h, M., Ordioni, U., Ahmed, H. M. A., Cohen, S., Catherine, J.-H., & Bukiet, F. (2017b). Sodium hypochlorite accident: a systematic review. Journal of Endodontics, 43(1), 16–24.
Hülsmann, M., & Hahn, W. (2000a). Complications during root canal irrigation–literature review and case reports. International Endodontic Journal, 33(3), 186–193.
Hülsmann, M., & Hahn, W. (2000b). Complications during root canal irrigation–literature review and case reports. International Endodontic Journal, 33(3), 186–193.
Othman, N. I. (2022). Hypochlorite Accident through Perforation: A Sequence of Iatrogenic Accidents. J Dental Health Oral Res, 3(1), 1–7.
Pontes, F., Pontes, H., Adachi, P., Rodini, C., Almeida, D., & Pinto Jr, D. (2008). Gingival and bone necrosis caused by accidental sodium hypochlorite injection instead of anaesthetic solution. International Endodontic Journal, 41(3), 267–270.
Roda, R. S. (2001). Root perforation repair: surgical and nonsurgical management. Practical Procedures & Aesthetic Dentistry: PPAD, 13(6), 467–472.
Sabala, C. L., & Powell, S. E. (1989a). Sodium hypochlorite injection into periapical tissues. Journal of Endodontics, 15(10), 490–492.
Sabala, C. L., & Powell, S. E. (1989b). Sodium hypochlorite injection into periapical tissues. Journal of Endodontics, 15(10), 490–492.
Salvadori, M., Venturi, G., Bertoletti, P., Francinelli, J., Tonini, R., Garo, M. L., & Salgarello, S. (2022). Sodium Hypochlorite Accident during Canal Treatment: Report of Four Cases Documented According to New Standards. Applied Sciences, 12(17), 8525.
Sonarkar, S. S., Singh, S., Podar, R., Kulkarni, G., & Purba, R. (2018). An in vivo comparison of the antibacterial efficacy of photoactivated disinfection, diode laser, and 5% sodium hypochlorite in root canal disinfection. Journal of Conservative Dentistry: JCD, 21(2), 205.
Tsesis, I., & Fuss, Z. V. I. (2006). Diagnosis and treatment of accidental root perforations. Endodontic Topics, 13(1), 95–107.
Wan, N. F., Ramlan, N. A., & Zohdi, N. M. (2024). Borneo Journal of Medical Sciences.
Witton, R., Henthorn, K., Ethunandan, M., Harmer, S., & Brennan, P. A. (2005). Neurological complications following extrusion of sodium hypochlorite solution during root canal treatment. International Endodontic Journal, 38(11), 843–848.
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