Clinical management of sodium hypochlorite lesions during endodontic treatment

Authors

Keywords:

sodium hypochlorite, endodontics, accidents, therapeutic irrigation, root canal irrigants, saline solution, root canal treatment.

Abstract

Introduction: In endodontic treatment, root canals must be irrigated; sodium hypochlorite is usually used. The accidents reported in these cases are due to anatomical circumstances, iatrogenic cases and due to errors in the irrigation technique.

Objective: To report the clinical management of three cases, injured during endodontic treatment by extrusion of hypochlorite to the periradicular tissues.

Case presentation: Female patients between 52 and 65 years of age. They presented with acute painful symptoms, burning, visible ecchymosis and erythema. A treatment protocol was proposed. Hypochlorite irrigation was discontinued and the procedure was suspended. The root canal was flushed with abundant saline solution, and antibiotics and analgesics were indicated. The event was explained to the patients. The symptoms resolved within eight to 15 days. Endodontic treatment was completed according to the evolution of each case.

Conclusions: Although there are guidelines for the management of complications produced by hypochlorite, they should be emphasized and measures should be established, before and during the procedure, to avoid this situation.

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References

1. Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Mark L, et al. Antimicrobial efficacy of chlorhexidine and sodium hypochlorite in root canal disinfection: a systematic review and meta-analysis of randomized controlled trials. J Endod. 2020;46(8):1032- 41.e7. DOI: https://doi.org/10.1016/j.joen.2020.05.002

2. Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: Different methods to improve efficacy and related problems. Eur J Dent. 2018;12(3):459-66. DOI: https://doi.org/10.4103/ejd.ejd_56_18

3. Santaella J, Palencia L, Weffer R. Materiales más utilizados en tratamientos endodónticos de dientes primarios. Revisión bibliográfica. RODYB. 2021 [acceso 20/02/2023];10(2):34-7. Disponible en: https://www.rodyb.com/wp-content/uploads/2021/05/5-materiales-mas-usados.pdf

4. Tartari T, Bachmann L, Garcia A, Bombarda F, Hungaro MA, Monteiro C. Tissue dissolution and modifications in dentin composition by different sodium hypochlorite concentrations. J Appl Oral Sci. 2016;24(3):291-8. DOI: https://doi.org/10.1590/1678-775720150524

5. Abuhaimed TS, Abou Neel EA. Sodium hypochlorite irrigation and its effect on bond strength to dentin. Biomed Res Int. 2017;2017:1930360. DOI: https://doi.org/10.1155/2017/1930360

6. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. Sodium hypochlorite accident: a systematic review. J Endod. 2017;43(1):16-24. DOI: https://doi.org/10.1016/j.joen.2016.09.023

7. Slaughter RJ, Watts M, Vale JA, Grieve JR, Schep LJ. The clinical toxicology of sodium hypochlorite. Clin Toxicol (Phila). 2019;57(5):303-11. DOI: https://doi.org/10.1080/15563650.2018.1543889

8. Gómez K, Quesada E, Fang L, Covo E. Accidente con hipoclorito de sodio durante la terapia endodóntica. Rev Cub Estomatol. 2018 [acceso 20/02/2023];55(2):1-7. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75072018000200006

9. Marín ML, Gómez B, Cano AD, Cruz S, Castañeda DA, Castillo EY. Hipoclorito de sodio como irrigante de conductos. Caso clínico y revisión de literatura. Av Odontoestomatol. 2019;35(1):33-43. DOI: https://dx.doi.org/10.4321/s0213-12852019000100005

10. Bither R, Bither S. Accidental extrusion of sodium hypochlorite during endodontic treatment: a case report. Glob J Dent Oral Hygiene. 2013 [acceso 20/02/2023];1(1):041-4. Disponible en: https://www.globalscienceresearchjournals.org/articles/accidental-extrusion-of-sodium-hypochlorite-during-endodontic-treatment-a-case-report.pdf

11. Farook SA, Shah V, Lenouvel D, Sheikh O, Sadiq Z, Cascarini L, et al. Guidelines for management of sodium hypochlorite extrusion injuries. Br Dent J. 2014;217(12):679-84. DOI: https://doi.org/10.1038/sj.bdj.2014.1099

12. Barrios OI, Anido EV, Morera PM. Declaración de Helsinki: cambios y exégesis. Rev Cub Sal Pública. 2016 [acceso 20/02/2023];42(1):132-42. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662016000100014

13. Vaz S, Tomazinho L, Holanda MI, Alburqueque A, Ribeiro M. Consequências e condutas clínicas frente a acidentes por extravasamento de NaClO em endodontias. Rev CES Odont. 2020;33(1):44-52. DOI: https://doi.org/10.21615/cesodon.33.1.6

14. Abramson A, Sabag E, Nahlieli O. Surgical approach to a severe case of sodium hypochlorite accident: a case report and review of the literature. Quintessence Int. 2021;52(9):806-10. DOI: https://doi.org/10.3290/j.qi.b1492001

15. Kanagasingam S, Blum IR. Sodium hypochlorite extrusion accidents: management and medico-legal considerations. Prim Dent J. 2020;9(4):59-63. DOI: https://doi.org/10.1177/2050168420963308

Published

2024-08-17

How to Cite

1.
Rendon Rojas D, Castro Castro M, Tovío Martínez E. Clinical management of sodium hypochlorite lesions during endodontic treatment. Rev Cubana Inv Bioméd [Internet]. 2024 Aug. 17 [cited 2025 Oct. 18];43. Available from: https://revibiomedica.sld.cu/index.php/ibi/article/view/2777

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Section

REPORTES DE CASOS