Limits...
Inadvertent apical extrusion of sodium hypochlorite with evaluation by dental volumetric tomography.

Başer Can ED, Karapınar Kazandağ M, Kaptan RF - Case Rep Dent (2015)

Bottom Line: The patient was followed up every other day and became asymptomatic on the 10th day.Endodontic therapy was completed with routine procedures.Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

View Article: PubMed Central - PubMed

Affiliation: Department of Endodontics, Faculty of Dentistry, Yeditepe University, Bagdat Caddesi 238, Göztepe, 34728 Istanbul, Turkey.

ABSTRACT
This case report describes the tissue injury caused by inadvertently extruded NaOCl through the apical constriction. A 56-year-old female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue complication due to apical extrusion of NaOCl was diagnosed. Antibiotics and analgesics were prescribed. DVT images revealed that the buccal root apex had perforated the maxillary bone. The patient was followed up every other day and became asymptomatic on the 10th day. Endodontic therapy was completed with routine procedures. Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

No MeSH data available.


Related in: MedlinePlus

An increase in the ecchymosis was noticed on the first recall.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4390169&req=5

fig3: An increase in the ecchymosis was noticed on the first recall.

Mentions: The root canals were irrigated with saline solution, and the tooth was restored temporarily. To prevent the risk of infection, intramuscular clindamycin (600 mg twice a day) was administered for three days, and ibuprofen (400 mg) was prescribed for pain management, to be taken as required. Use of cold packs externally for the first day was replaced by warm compresses on the second day for treatment of the swelling. On the first recall, an increase in the ecchymosis was noticed; however, the swelling had decreased significantly (Figure 3). Both swelling and ecchymosis kept progressively decreasing during the follow-up period, and the patient became asymptomatic on the 10th day after the procedure (Figure 4). For the evaluation of the relationship between the tooth, alveolar bone, and the maxillary sinus, dental volumetric tomography (DVT) (Newtom 3G, QR s.r.l., Verona, Italy) was performed. DVT images revealed that the apex of the buccal root canal had perforated the maxillary cortical bone, creating a pathway for the solution into the soft tissues (Figures 5(a) and 5(b)). After 10 days, the symptoms had completely resolved. At this time, a root canal dressing with Ca(OH)2 was placed in the canal. At the final appointment approximately 4 weeks after the procedure, the root canals were filled with AH Plus (Dentsply Maillefer) and gutta-percha (Figure 6).


Inadvertent apical extrusion of sodium hypochlorite with evaluation by dental volumetric tomography.

Başer Can ED, Karapınar Kazandağ M, Kaptan RF - Case Rep Dent (2015)

An increase in the ecchymosis was noticed on the first recall.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4390169&req=5

fig3: An increase in the ecchymosis was noticed on the first recall.
Mentions: The root canals were irrigated with saline solution, and the tooth was restored temporarily. To prevent the risk of infection, intramuscular clindamycin (600 mg twice a day) was administered for three days, and ibuprofen (400 mg) was prescribed for pain management, to be taken as required. Use of cold packs externally for the first day was replaced by warm compresses on the second day for treatment of the swelling. On the first recall, an increase in the ecchymosis was noticed; however, the swelling had decreased significantly (Figure 3). Both swelling and ecchymosis kept progressively decreasing during the follow-up period, and the patient became asymptomatic on the 10th day after the procedure (Figure 4). For the evaluation of the relationship between the tooth, alveolar bone, and the maxillary sinus, dental volumetric tomography (DVT) (Newtom 3G, QR s.r.l., Verona, Italy) was performed. DVT images revealed that the apex of the buccal root canal had perforated the maxillary cortical bone, creating a pathway for the solution into the soft tissues (Figures 5(a) and 5(b)). After 10 days, the symptoms had completely resolved. At this time, a root canal dressing with Ca(OH)2 was placed in the canal. At the final appointment approximately 4 weeks after the procedure, the root canals were filled with AH Plus (Dentsply Maillefer) and gutta-percha (Figure 6).

Bottom Line: The patient was followed up every other day and became asymptomatic on the 10th day.Endodontic therapy was completed with routine procedures.Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

View Article: PubMed Central - PubMed

Affiliation: Department of Endodontics, Faculty of Dentistry, Yeditepe University, Bagdat Caddesi 238, Göztepe, 34728 Istanbul, Turkey.

ABSTRACT
This case report describes the tissue injury caused by inadvertently extruded NaOCl through the apical constriction. A 56-year-old female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue complication due to apical extrusion of NaOCl was diagnosed. Antibiotics and analgesics were prescribed. DVT images revealed that the buccal root apex had perforated the maxillary bone. The patient was followed up every other day and became asymptomatic on the 10th day. Endodontic therapy was completed with routine procedures. Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

No MeSH data available.


Related in: MedlinePlus