sodium-hypochlorite and Facial-Pain

The literature concerning the etiology, symptomatology and management of complications during root canal irrigation is reviewed. Clinical symptoms are discussed, as well as preventive and therapeutic considerations.

Topics: Burns, Chemical; Cornea; Extravasation of Diagnostic and Therapeutic Materials; Eye Burns; Facial Pain; Humans; Periapical Tissue; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Therapeutic Irrigation

The effects of an inadvertent injection of sodium hypochlorite into the cheek during irrigation of the right maxillary central incisor root canal are reported. The patient suffered from severe pain, edema, and necrosis of subcutaneous tissues and mucosa. Surgical intervention was necessary to contain the destructive process which extended from the upper lip to the right eye. The histopathological examination demonstrated the high cytotoxicity of sodium hypochlorite on vital tissue.

Topics: Adult; Burns, Chemical; Cheek; Edema; Facial Pain; Female; Humans; Iatrogenic Disease; Root Canal Irrigants; Sodium Hypochlorite

A 66-year-old female patient presented to the accident and emergency department, 3 h following a dental appointment. Significant right-sided facial swelling, bruising and pain were present. The patient had been sent by her general dental practitioner with a covering letter explaining that a hypochlorite accident had occurred during root canal treatment of the upper right first premolar tooth. An iatrogenic perforation was suspected. The patient was admitted under the care of the maxillofacial team and intravenous antibiotics, analgesia and steroids were administered. The patient was prepared for the possibility of requiring surgical intervention under a general anaesthetic. No nerve injury was encountered and the periorbital tissues were spared. A full recovery was made by the patient with no surgical intervention required but significant bruising and swelling were present up to 4 weeks following the incident.

Topics: Acetaminophen; Aged; Amoxicillin-Potassium Clavulanate Combination; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; beta-Lactamase Inhibitors; Cone-Beam Computed Tomography; Dexamethasone; Edema; Facial Pain; Female; Humans; Iatrogenic Disease; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Tooth Apex; Treatment Outcome

Sodium hypochlorite (NaOCl) is most commonly used as an irrigating solution in endodontic practice. This paper describes an incident of sodium hypochlorite extrusion past the apex (SHEPA) of the UR3. Management of the condition resulted in hospitalisation of the patient, and intravenous antibiotic and steroid therapy. This case report details the measures that can be employed to reduce the risk of SHEPA and management of its potentially serious complications. The reader should understand the various measures that can be adopted to reduce extrusion of endodontic irrigants beyond the root apex and management following SHEPA.

Topics: Amoxicillin; Anti-Bacterial Agents; Dexamethasone; Diplopia; Edema; Extravasation of Diagnostic and Therapeutic Materials; Facial Pain; Female; Glucocorticoids; Humans; Middle Aged; Periapical Tissue; Root Canal Irrigants; Sodium Hypochlorite; Tooth Apex

To show the radiographic manifestation of sodium hypochlorite after accidental injection past the apical foramen and into the soft tissues.. A female patient was seen for an emergency visit after suffering a sodium hypochlorite accident at her general dentist's office. The patient was seen within 1 h of the accident and was in pain associated with facial swelling. Radiographs, including a Cone Beam Computed Tomography (CBCT), and photographs were taken. Endodontic emergency treatment was initiated. The patient was reassured and given pain medication and antibiotics. Follow-up visits were scheduled over 6 days when the swelling had resolved.. • Importance of multiple radiographic images during preoperative endodontic evaluation when undertaking endodontic retreatment. • Knowledge of apical anatomy as related to surrounding structures. • Effect of sodium hypochlorite when injected in the soft tissues.

Topics: Adult; Cheek; Cone-Beam Computed Tomography; Edema; Exudates and Transudates; Facial Pain; Female; Follow-Up Studies; Humans; Periapical Tissue; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Subcutaneous Tissue; Tooth Apex

A previously undocumented complication of root canal therapy is reported. A dilute solution of 5-10 mls sodium hypochlorite was inadvertently injected into the maxillary sinus during root canal therapy of a right upper second premolar (5). The patient developed acute, sudden, severe facial pain and swelling necessitating emergency admission to hospital and operative intervention under general anaesthesia. A diagnosis of acute chemical sinusitus was made, further management and discussion follow.

Topics: Accidents; Acute Disease; Adult; Anti-Infective Agents, Local; Bicuspid; Edema; Facial Pain; Humans; Injections; Male; Maxillary Sinus; Maxillary Sinusitis; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite

The following case report demonstrates the tissue changes that may occur when sodium hypochlorite, an irrigant used for debridement of the root canal system, is inadvertently injected into periapical tissues.

Topics: Adult; Drug Hypersensitivity; Facial Pain; Female; Humans; Hypersensitivity, Immediate; Injections; Lip; Periapical Tissue; Root Canal Irrigants; Sodium Hypochlorite

In endodontic treatment, solutions of sodium hypochlorite are widely used as an irrigating agent. It is an effective solvent of both necrotic and vital tissues, which makes it toxic to the surrounding tissues. Complications are rarely reported. Nevertheless, the acute symptoms caused by the toxic reaction must not be underestimated. Causes, treatment, and prevention of complications of sodium hypochlorite use are discussed, and three case reports are presented.

Topics: Adult; Anti-Bacterial Agents; Facial Pain; Female; Humans; Male; Mouth Mucosa; Naproxen; Root Canal Irrigants; Sodium Hypochlorite