sodium-hypochlorite and Ecchymosis

Root canal treatment forms an essential part of general dental practice. Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics due to its ability to dissolve organic soft tissues in the root canal system and its action as a potent antimicrobial agent. Although NaOCl accidents created by extrusion of the irrigant through root apices are relatively rare and are seldom life-threatening, they do create substantial morbidity when they occur.. To date, NaOCl accidents have only been published as isolated case reports. Although previous studies have attempted to summarise the symptoms involved in these case reports, there was no endeavour to analyse the distribution of soft tissue distribution in those reports. In this review, the anatomy of a classical NaOCl accident that involves facial swelling and ecchymosis is discussed.. By summarising the facial manifestations presented in previous case reports, a novel hypothesis that involves intravenous infusion of extruded NaOCl into the facial vein via non-collapsible venous sinusoids within the cancellous bone is presented.. Understanding the mechanism involved in precipitating a classic NaOCl accident will enable the profession to make the best decision regarding the choice of irrigant delivery techniques in root canal débridement, and for manufacturers to design and improve their irrigation systems to achieve maximum safety and efficient cleanliness of the root canal system.

Topics: Accidents; Ecchymosis; Edema; Extravasation of Diagnostic and Therapeutic Materials; Facial Dermatoses; Humans; Root Canal Irrigants; Sodium Hypochlorite

Sodium hypochlorite (bleach) is commonly used as an irrigant during dental procedures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI). In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

Topics: Acute Kidney Injury; Dental Caries; Ecchymosis; Edema; Humans; Iatrogenic Disease; Injections; Kidney Tubules; Medication Errors; Oxidants; Sodium Hypochlorite

A sodium hypochlorite accident is a rare event in adults, but even more so in children. The purposes of this paper were to: report the case of a one-year, 10-month-old toddler who was treated under general anesthesia for early childhood caries, incurred a sodium hypochlorite accident following attempted pulpectomy in his primary maxillary central incisors, but made a full recovery without any sequelae after a typical four to six weeks course of disease; review the pertinent literature; and give recommendations on how to minimize the potential occurrence of such incidents.

Topics: Anesthesia, Dental; Anesthesia, General; Dental Caries; Dental Pulp Exposure; Ecchymosis; Edema; Facial Dermatoses; Humans; Incisor; Infant; Maxilla; Pulpectomy; Pulpitis; Root Canal Irrigants; Sodium Hypochlorite; Tooth, Deciduous

Topics: Adult; Cheek; Disinfectants; Ecchymosis; Edema; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Necrosis; Orbit; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite

Topics: Adult; Ecchymosis; Edema; Face; Female; Hematoma; Humans; Root Canal Irrigants; Sodium Hypochlorite; Tomography, X-Ray Computed

Sodium hypochlorite solution is toxic to vital tissues, causing severe effects if extruded during endodontic treatment. This paper presents a report on the tissue damage related to inadvertent extrusion of concentrated sodium hypochlorite solution during root canal treatment. A 65-year-old woman was referred with moderate pain, ecchymosis, and severe swelling of the right side of the face. These symptoms appeared immediately after a root canal treatment of the maxillary right canine, which had been started 21 hours earlier. It was diagnosed as air emphysema related to sodium hypochlorite solution extravasation during the endodontic treatment. To avoid this, an initial radiograph should be taken to determine the correct canal working length and confirm root canal integrity.

Topics: Aged; Dental Fistula; Ecchymosis; Edema; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Periapical Abscess; Periapical Tissue; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Subcutaneous Emphysema

Sodium hypochlorite (NaOCl) is currently used in the debridement and disinfection of the root canal system, supporting the mechanical procedures. Although it is considered a safe irrigant, the literature reports a few cases of adverse reaction caused by NaOCl: They range from injection through the apical foramen to air emphysema and allergic reactions as complications during endodontic treatment. The present report shows the possible severe clinical consequences of concentrated NaOCl extruding through the periapical tissues during root canal irrigation in a patient not allergic to NaOCl.

Topics: Adult; Cheek; Ecchymosis; Edema; Female; Humans; Incisor; Lip; Maxilla; Mouth Mucosa; Periapical Tissue; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite

Sodium hypochlorite (NaOCl) is a well documented and widely accepted intracanal irrigant used to disinfect the pulp space in endodontic therapy. NaOCl can be an extremely cytotoxic material; therefore, care must be taken with its use. The authors present a case of periradicular extravasation of NaOCl with sequelae of pain, swelling, ecchymosis and parasthesia consistent with a chemical burn. The patient was treated with a nonsurgical medical management approach. She experienced a complete resolution of signs and symptoms, aside from a persistent residual focal parasthesia.

Topics: Bicuspid; Burns, Chemical; Ecchymosis; Edema; Extravasation of Diagnostic and Therapeutic Materials; Face; Female; Humans; Maxilla; Middle Aged; Paresthesia; Periapical Tissue; Root Canal Irrigants; Sodium Hypochlorite

Sodium hypochlorite, or NaOCl, is one of the most commonly used irrigating solutions in endodontic practice. Its clinically proven antibacterial, solvent and lubricating properties make it a very appealing choice as an intracanal medicament.. The authors present a case of facial hematoma formation after an inadvertent injection of NaOCl into the periapical tissues. The NaOCl solution caused extensive tissue destruction. Management of the condition required the hospitalization, intravenous antibiotic therapy and multiple intraoral surgical incisions to facilitate drainage.. Use of NaOCl must be confined to the root canal system. This report reviews this intracanal medicament's potential toxicity and emphasizes the need for clinicians to remain cognizant of possible problems while using the solution.

Topics: Cellulitis; Cuspid; Ecchymosis; Face; Female; Hematoma; Humans; Medical Errors; Middle Aged; Orbital Diseases; Periapical Tissue; Root Canal Irrigants; Root Canal Obturation; Sodium Hypochlorite

Topics: Ecchymosis; Edema; Face; Female; Humans; Middle Aged; Root Canal Therapy; Sodium Hypochlorite

Sodium hypochlorite is a useful adjunct to endodontic therapy but it must be confined to the root canal. A case of periapical injection of hypochlorite with untoward sequellae is presented.

Topics: Ecchymosis; Edema; Humans; Male; Middle Aged; Periapical Tissue; Root Canal Irrigants; Sodium Hypochlorite