Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Accidental Extrusion of Sodium Hypochlorite during Endodontic Treatment in a Primary Tooth

유치의 근관 치료 중 차아염소산나트륨의 치근단 유입으로 인한 합병증

  • Kim, Minji (Department of Pediatric Dentistry, Sun Dental Hospital) ;
  • Kim, Jinyoung (Department of Pediatric Dentistry, Sun Dental Hospital) ;
  • Lim, Sumin (Department of Pediatric Dentistry, Sun Dental Hospital)
  • Received : 2014.10.27
  • Accepted : 2014.12.03
  • Published : 2015.08.31
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Abstract

Although sodium hypochlorite is the most frequently used canal irrigant during endodontic treatment, its complications are not as well recognized as its effectiveness. This report demonstrates that sodium hypochlorite extrusion during endodontic treatment can cause severe complications. A 5-year-old boy experienced immediate pain and swelling, ecchymosis in surrounding tissues, and profuse bleeding from the root canal during endodontic treatment, because of accidental extrusion of sodium hypochlorite. The patient was hospitalized, and analgesics and antibiotics were prescribed. Accidental extrusion of the irrigating solution occurs more frequently in teeth with immature apices, root resorption, and apical perforations; therefore, caution is needed. When such complications occur, proper management and medications are needed.

차아염소산나트륨은 가장 자주 쓰이는 근관 세척제이지만, 그 독성과 부작용에 대해서는 많이 인식되어 있지 않다. 본 증례는 근관 치료 중 차아염소산나트륨이 치근단 조직으로 압출되어 심각한 합병증이 발생하였기에 이를 보고하는 바이다. 만 5세의 남자 환자에서 근관 치료 중 차아염소산나트륨이 치근단 조직으로 유입되어 갑작스런 통증 및 부종, 주위 조직의 피하출혈 그리고 근관 내의 지속적 출혈을 보였다. 환자는 입원치료를 받았고, 진통제와 항생제를 처방받았다. 근단공이 넓은 미성숙 영구치와 유치, 치근흡수, 천공이 일어난 치아에서는 근관 치료 시 차아염소산나트륨이 압출되지 않도록 더욱 각별한 주의가 필요하다. 합병증이 발생하였을 때에는 적절한 환자의 관리와 약물치료가 필요하다.

Keywords

References

  1. Fanning EA : Effects of extraction of deciduous molars on the formation and eruption of their successors. The Angle Ortho, 32:44-53, 1962.
  2. Rodd HD, Waterhouse PJ, Moffat MA, et al. : Pulp therapy for primary molars. Int J Paediatr Dent, 16:15-23, 2006. https://doi.org/10.1111/j.1365-263X.2006.00774.x
  3. Thomas AM, Chandra S, Chandra S, Pandey RK : Elimination of infection in pulectomized deciduous teeth: a short-term study. J Endod, 20:233-235, 1994. https://doi.org/10.1016/S0099-2399(06)80284-0
  4. Tirali RE, Bodur H, Ece G : In vitro antimicrobial activity of Sodium hypochlorite, Chlorhexidine gluconate and Octenidine Dihydrochloride in elimination of microorganisms within dentinal tubules of primary and permanent teeth. Med Oral Patol Oral Cir Bucal, 17:517-522, 2012.
  5. Marion JJC, Manhaães FC, Bajo H, Duque TM : Efficiency of different concentrations of sodium hypochlorite during endodontic treatment. Literature review. Dental Press Endod, 2:32-37, 2012.
  6. 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
  7. Zhang W, Torabinejad M, Li Y : Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method. J Endod, 29:654-657, 2003. https://doi.org/10.1097/00004770-200310000-00010
  8. Vianna ME, Gomes BP, Souza-Filho FJ, et al. : In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 97:79-84, 2004. https://doi.org/10.1016/S1079-2104(03)00360-3
  9. 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
  10. Bosch-Aranda ML, Canalda-Sahli C, Figueiredo R, Gay-Escoda C : Complications following an accidental sodium hypochlorite extrusion: A report of two cases. J Clin Exp Dent, 4:194-198, 2012.
  11. Wang SH, Chung MP, Shieh YS, et al. : Sodium Hypochlorite Accidentally Extruded Beyond the Apical Foramen. J Med Sci, 30:61-65, 2010.
  12. Hong SY, Kim JW, Ahn BD, et al. : Complications of Sodium Hypochlorite during Re-endodontic Treatment of Maxillary Primary Central Incisor: A Case Report. J Korean Acad Pediatr Dent, 39:186-191, 2012. https://doi.org/10.5933/JKAPD.2012.39.2.186
  13. Rungcharoenporn N, Pimkhaokham S : Comparison in amount of sodium hypochlorite extrusion during irrigation with needle-syringe and EndoActivator: in vitro study. CU Dent J, 37:39-46, 2014.
  14. Mohammadi Z : Sodium hypochlorite in endodontics: an update review. Int Dent J, 58:329-341, 2008. https://doi.org/10.1111/j.1875-595X.2008.tb00354.x
  15. Hauman CH, Love RM : Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 1. Intracanal drugs and substances. Int Endod J, 36:75-85, 2003. https://doi.org/10.1046/j.1365-2591.2003.00631.x
  16. Ehrich DG, Brian JD Jr, Walker WA : Sodium hypochlorite accident: inadvertent injection into the maxillary sinus. J Endod, 19:180-182, 1993. https://doi.org/10.1016/S0099-2399(06)80684-9
  17. 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
  18. Boutsioukis C, Verhaagen B, van der Sluis LW, et al. : Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod, 36:875-879, 2010. https://doi.org/10.1016/j.joen.2009.12.026
  19. Mitchell RP, Yang SE, Baumgarter JC : Comparison of Apical Extrusion of NaOCl Using the EndoVac or Needle Irrigation of Root Canals. J Endod, 36:338-341, 2010. https://doi.org/10.1016/j.joen.2009.10.003
  20. Desai P, Himel V : Comparative Safety of Various Intracanal Irrigation Systems. J Endod, 35:545-549, 2009. https://doi.org/10.1016/j.joen.2009.01.011
  21. Gomes BPFA, Ferraz CCR, Souza-Filho FJ, 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
  22. Gursoy UK, Bostanci V, Kosger HH : Palatal mucosa necrosis because of accidental sodium hypochlorite injection instead of anaesthetic solution. Int Endod J, 39:157-161, 2006. https://doi.org/10.1111/j.1365-2591.2006.01067.x
  23. Naenni N, Thoma K, Zehnder M : Soft tissue dissolution capacity of current used and potential endodontic irrigants. J Endod, 30:785-787, 2004. https://doi.org/10.1097/00004770-200411000-00009

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