Anatomy of sodium hypochlorite accidents involving facial ecchymosis - a review.

Abstract:

OBJECTIVES: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. METHODS: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. RESULTS: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. CONCLUSIONS: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.

journal_name

J Dent

journal_title

Journal of dentistry

authors

Zhu WC,Gyamfi J,Niu LN,Schoeffel GJ,Liu SY,Santarcangelo F,Khan S,Tay KC,Pashley DH,Tay FR

doi

10.1016/j.jdent.2013.08.012

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

935-48

issue

11

eissn

0300-5712

issn

1879-176X

pii

S0300-5712(13)00216-9

journal_volume

41

pub_type

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