대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제39권2호
  • /
  • Pages.186-191
  • /
  • 2012
  • /
  • 1226-8496(pISSN)
  • /
  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지
DOI QR코드

DOI QR Code

상악 유중절치 재근관 치료에서 차아염소산나트륨의 합병증에 대한 증례 보고

COMPLICATIONS OF SODIUM HYPOCHLORITE DURING RE-ENDODONTIC TREATMENT OF MAXILLARY PRIMARY CENTRAL INCISOR : A CASE REPORT

  • 홍소이 (이화여자대학교 목동병원 소아치과) ;
  • 김진우 (이화여자대학교 목동병원 구강악안면외과) ;
  • 김지연 (이화여자대학교 목동병원 구강악안면외과) ;
  • 마연주 (이화여자대학교 목동병원 소아치과) ;
  • 안병덕 (소아치과, 이화여자대학교 의학전문대학원 치과학교실 소아치과학전공)
  • Hong, So-Yi (Division of Pediatric Dentistry, Department of Dentistry, Ewha Womans University Mokdong Hospital) ;
  • Kim, Jin-Woo (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ewha Womans University Mokdong Hospital) ;
  • Kim, Ji-Youn (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ewha Womans University Mokdong Hospital) ;
  • Mah, Yon-Joo (Division of Pediatric Dentistry, Department of Dentistry, Ewha Womans University Mokdong Hospital) ;
  • Ahn, Byung-Duk (Division of Pediatric Dentistry, Department of Dentistry, School of Medicine, Ewha Womans University)
  • 투고 : 2012.02.15
  • 심사 : 2012.05.09
  • 발행 : 2012.05.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

차아염소산나트륨은 근관 세척 시 널리 쓰이는 약제이다. 근관계의 멸균에는 효과적이나, 부작용에 대해서는 알려진 바가 많지 않으며 특히 유치에서 근관세척제로 사용 시 부작용에 대한 보고는 거의 없었다. 본 증례는 차아염소산나트륨이 유치의 치근단을 통과하였을 때 심각한 부작용을 일으킬 수 있음을 보여준다. 만 4세 여아가 치과의원에서 차아염소산나트륨을 이용한 상악 유중절치의 재근관 치료 중 급격한 안면 부종과 통증으로 본원 응급실로 의뢰되었다. 전신적 스테로이드제, 항히스타민제, 항생제 및 진통제를 투여하고, 해당 치아는 2차 감염 예방을 위해 발거하였다. 2일 후 부종이 감소하기 시작하였다. 차아염소산나트륨에 대한 알레르기 반응 검사 결과 음성을 나타내었다. 유치의 근관 세척 시에는 차아염소산나트륨이 치주조직으로 압출되지 않도록 철저히 주의해야 하며, 부작용이 일어날 경우 통증 및 부종 완화와 약물 치료가 필요하다.

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia, cold compression and adequate medication should be done.

키워드

참고문헌

  1. Gernhardt CR, Eppendorf K, Kozlowski A, et al.: Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant. Int Endod J, 37:272-280, 2004. https://doi.org/10.1111/j.0143-2885.2004.00804.x
  2. Spencer HR, Ike V, Brennan PA: Review: the use of sodium hypochlorite in endodontics-potential complications and their management. Br Dent J, 202:555-559, 2007. https://doi.org/10.1038/bdj.2007.374
  3. Crincoli V, Scivetti M, Di Bisceglie MB, et al.: Unusual case of adverse reaction in the use of sodium hypochlorite during endodontic treatment: a case report. Quintessence Int, 39:e70-73, 2008.
  4. Becking AG: Complications in the use of sodium hypochlorite during endodontic treatment. Report of three cases. Oral Surg Oral Med Oral Pathol, 71:346-348, 1991. https://doi.org/10.1016/0030-4220(91)90313-2
  5. Kerbl FM, DeVilliers P, Litaker M, et al.: Physical effects of sodium hypochlorite on bone: an ex vivo study. J Endod, 38:357-359, 2012. https://doi.org/10.1016/j.joen.2011.12.031
  6. Imura N, Zuolo ML: Factors associated with endodontic flare-ups: a prospective study. Int Endod J, 28:261-265, 1995. https://doi.org/10.1111/j.1365-2591.1995.tb00311.x
  7. Trope M: Flare-up rate of single-visit endodontics. Int Endod J, 24:24-26, 1991. https://doi.org/10.1111/j.1365-2591.1991.tb00866.x
  8. Torabinejad M, Kettering JD, McGraw JC, et al.: Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps. J Endod, 14:261-266, 1988. https://doi.org/10.1016/S0099-2399(88)80181-X
  9. Pickenpaugh L, Reader A, Beck M, et al.: Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth. J Endod, 27:53-56, 2001. https://doi.org/10.1097/00004770-200101000-00019
  10. Walton R, Fouad A: Endodontic interappointment flare-ups: a prospective study of incidence and related factors. J Endod, 18:172-177, 1992. https://doi.org/10.1016/S0099-2399(06)81413-5
  11. Jacobsen AHN: Allergic reactions in endodontic practice. Endodontic Topics, 12:44-51, 2005. https://doi.org/10.1111/j.1601-1546.2005.00195.x
  12. Dandakis C, Lambrianidis T, Boura P: Immunologic evaluation of dental patient with history of hypersensitivity reaction to sodium hypochlorite. Endod Dent Traumatol, 16:184-187, 2000. https://doi.org/10.1034/j.1600-9657.2000.016004184.x
  13. Kaufman AY, Keila S: Hypersensitivity to sodium hypochlorite. J Endod, 15:224-226, 1989. https://doi.org/10.1016/S0099-2399(89)80241-9
  14. Hulsmann M, Hahn W: Complications during root canal irrigation--literature review and case reports. Int Endod J, 33:186-193, 2000. https://doi.org/10.1046/j.1365-2591.2000.00303.x
  15. Mitchell RP, Baumgartner JC, Sedgley CM: Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod, 37:1677-1681, 2011. https://doi.org/10.1016/j.joen.2011.09.004
  16. Manogue M PS, Walker R.: The principles of endodontics. 139 edn. Oxford university press, oxford, 138-139. 2005.
  17. Vande Visse JE, Brilliant JD: Effect of irrigation on the production of extruded material at the root apex during instrumentation. J Endod, 1:243-246, 1975. https://doi.org/10.1016/S0099-2399(75)80227-5
  18. Brown DC, Moore BK, Brown CE, Jr., Newton CW: An in vitro study of apical extrusion of sodium hypochlorite during endodontic canal preparation. J Endod, 21:587-591, 1995. https://doi.org/10.1016/S0099-2399(06)81108-8
  19. Baumgartner JC, Cuenin PR: Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. J Endod, 18:605-612, 1992. https://doi.org/10.1016/S0099-2399(06)81331-2
  20. Harrison JW, Gaumgartner JC, Svec TA: Incidence of pain associated with clinical factors during and after root canal therapy. Part 1. Interappointment pain. J Endod, 9:384-387, 1983. https://doi.org/10.1016/S0099-2399(83)80190-3
  21. Harrison JW, Baumgartner JC, Svec TA: Incidence of pain associated with clinical factors during and after root canal therapy. Part 2. Postobturation pain. J Endod, 9:434-438, 1983. https://doi.org/10.1016/S0099-2399(83)80259-3
  22. Spangberg L, Langeland K: Biologic effects of dental materials. 1. Toxicity of root canal filling materials on HeLa cells in vitro. Oral Surg Oral Med Oral Pathol, 35:402-414, 1973. https://doi.org/10.1016/0030-4220(73)90078-9
  23. Yesilsoy C, Whitaker E, Cleveland D, et al.: Antimicrobial and toxic effects of established and potential root canal irrigants. J Endod, 21:513-515, 1995. https://doi.org/10.1016/S0099-2399(06)80524-8
  24. Heling I, Sommer M, Steinberg D, et al.: Microbiological evaluation of the efficacy of chlorhexidine in a sustained-release device for dentine sterilization. Int Endod J, 25:15-19, 1992. https://doi.org/10.1111/j.1365-2591.1992.tb00943.x
  25. Gomes BP, Ferraz CC, Vianna ME, et al.: In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J, 34:424-428, 2001. https://doi.org/10.1046/j.1365-2591.2001.00410.x
  26. Sirtes G, Waltimo T, Schaetzle M, Zehnder M: The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod, 31:669-671, 2005. https://doi.org/10.1097/01.don.0000153846.62144.d2

피인용 문헌

  1. Accidental Extrusion of Sodium Hypochlorite during Endodontic Treatment in a Primary Tooth vol.42, pp.3, 2015, https://doi.org/10.5933/JKAPD.2015.42.3.264