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Adverse Reaction of Sodium Hypochlorite during Endodontic Treatment of Primary Teeth.

Chaugule VB, Panse AM, Gawali PN - Int J Clin Pediatr Dent (2015)

Bottom Line: Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features.Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child.Int J Clin Pediatr Dent 2015;8(2):153-156.

View Article: PubMed Central - PubMed

Affiliation: Professor and Head, Department of Pedodontics, Sinhgad Dental College, Pune Maharashtra, India.

ABSTRACT
Sodium hypochlorite (NaOCl) is the most common and effective intracanal medicament used in root canal treatments, because of its low-cost and a very effective antimicrobial activity against microbiota of infected root canals. Sodium hypochlorite is an effective intracanal irrigant and is used in concentrations ranging from 0.5 to 5.25%. At these concentrations, it is highly hypertonic and strongly alkaline with pH 11 to 13. Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features. Most of the complications are the result of accidental extrusion of the solution from the apical foramen or accessory canals or perforations into the periapical area. Although it is an effective solution for disinfection of root canal system, fewer incidence of complications are reported, especially in primary teeth. Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child. How to cite this article: Chaugule VB, Panse AM, Gawali PN. Adverse Reaction of Sodium Hypochlorite during Endo-dontic Treatment of Primary Teeth. Int J Clin Pediatr Dent 2015;8(2):153-156.

No MeSH data available.


Related in: MedlinePlus

Swelling extending from the left infraorbital margin to angle of mandible
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Figure 1: Swelling extending from the left infraorbital margin to angle of mandible

Mentions: A 4-year-old girl reported to the Department of Pedodontics and Preventive Dentistry, Sinhgad Dental College and Hospital with chief complaint of a carious lesion in the upper left posterior region. On clinical examination, a deep occlusal carious lesion approaching the pulp was seen in upper left 1st and 2nd primary molars. No periapical pathology was evident. Radiographic interpretation suggested the need of pulpectomy for both primary molars. Pulpectomy procedure was initiated after administration of the local anesthesia. Access cavity was prepared and the working length was determined. Intermittent canal irrigation with 3% NaOCl was carried out whilst the biomechanical preparation of root canals was on. During instrumentation, due to profuse bleeding, copious irrigation with hypochlorite had to be carried out. While irrigating a sudden spontaneous extraoral swelling was observed on the left side of the face which increased gradually extending from the left infraorbital margin to angle of mandible and the patient experienced severe pain (Figs 1A and B). On palpation, the swelling was soft and diffuse. Crepitus was felt on palpation of periorbital swelling and mouth opening was not at all restricted.


Adverse Reaction of Sodium Hypochlorite during Endodontic Treatment of Primary Teeth.

Chaugule VB, Panse AM, Gawali PN - Int J Clin Pediatr Dent (2015)

Swelling extending from the left infraorbital margin to angle of mandible
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562052&req=5

Figure 1: Swelling extending from the left infraorbital margin to angle of mandible
Mentions: A 4-year-old girl reported to the Department of Pedodontics and Preventive Dentistry, Sinhgad Dental College and Hospital with chief complaint of a carious lesion in the upper left posterior region. On clinical examination, a deep occlusal carious lesion approaching the pulp was seen in upper left 1st and 2nd primary molars. No periapical pathology was evident. Radiographic interpretation suggested the need of pulpectomy for both primary molars. Pulpectomy procedure was initiated after administration of the local anesthesia. Access cavity was prepared and the working length was determined. Intermittent canal irrigation with 3% NaOCl was carried out whilst the biomechanical preparation of root canals was on. During instrumentation, due to profuse bleeding, copious irrigation with hypochlorite had to be carried out. While irrigating a sudden spontaneous extraoral swelling was observed on the left side of the face which increased gradually extending from the left infraorbital margin to angle of mandible and the patient experienced severe pain (Figs 1A and B). On palpation, the swelling was soft and diffuse. Crepitus was felt on palpation of periorbital swelling and mouth opening was not at all restricted.

Bottom Line: Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features.Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child.Int J Clin Pediatr Dent 2015;8(2):153-156.

View Article: PubMed Central - PubMed

Affiliation: Professor and Head, Department of Pedodontics, Sinhgad Dental College, Pune Maharashtra, India.

ABSTRACT
Sodium hypochlorite (NaOCl) is the most common and effective intracanal medicament used in root canal treatments, because of its low-cost and a very effective antimicrobial activity against microbiota of infected root canals. Sodium hypochlorite is an effective intracanal irrigant and is used in concentrations ranging from 0.5 to 5.25%. At these concentrations, it is highly hypertonic and strongly alkaline with pH 11 to 13. Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features. Most of the complications are the result of accidental extrusion of the solution from the apical foramen or accessory canals or perforations into the periapical area. Although it is an effective solution for disinfection of root canal system, fewer incidence of complications are reported, especially in primary teeth. Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child. How to cite this article: Chaugule VB, Panse AM, Gawali PN. Adverse Reaction of Sodium Hypochlorite during Endo-dontic Treatment of Primary Teeth. Int J Clin Pediatr Dent 2015;8(2):153-156.

No MeSH data available.


Related in: MedlinePlus