Necrosis of gingiva and alveolar bone caused by accidental sodium hypochlorite seepage during endodontic treatment

Sajjan, GS; Dwarakanath, CD; Nalam, N. V. D.; Singamsetty, Satya Kalyani

doi:10.4103/2229-5194.142952

Cited by 1 publication

(2 citation statements)

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“…All soft necrotic tissues fully resolved within a few weeks. About bone tissue necrosis, one patient had gingival necrosis that evolved to bone necrosis, 27 and the other patient had a necrotic lesion of the vestibular plate that evolved to jaw osteonecrosis a few weeks later despite curettage of the necrotic bone, chlorhexidine applications and systemic antibiotherapy 52 …”

Section: Resultsmentioning

confidence: 99%

“…30 All soft necrotic tissues fully resolved within a few weeks. About bone tissue necrosis, one patient had gingival necrosis that evolved to bone necrosis, 27 and the other patient had a necrotic lesion of the vestibular plate that evolved to jaw osteonecrosis a few weeks later despite curettage of the necrotic bone, chlorhexidine applications and systemic antibiotherapy. 52 Regarding the eight patients with ocular disorders, three developed a decrease in visual acuity, one had a blepharospasm that lasted 1 year, 13 one developed a downward diplopia in the right eye and a limitation of movements, 35 and one had pain in the right eye with uneven coloration of the cornea.…”

Section: General Characteristics Of Casesmentioning

confidence: 99%

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Sodium hypochlorite accident diagnosis and management: Analysis from the literature and the French pharmacovigilance database

Kartit,

Delacroix,

Clement

et al. 2024

Fundamemntal Clinical Pharma

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PurposeSodium hypochlorite (NaOCl) is considered as the reference irrigation solution in endodontics. However, NaOCl‐related accidents may occur, and non‐dentist health professionals might under‐recognize this rare adverse effect although it is potentially severe, with possible medical and aesthetic sequelae. We performed a literature review to provide to non‐dentist healthcare professionals a large picture of symptoms, management and potential consequences of NaOCl accidents.MethodsWe queried PubMed and the French Pharmacovigilance database and retrieved 76 cases for analysis (70 from 57 published articles, and six from the database).ResultsThe analysis showed that patients were mostly women (79%), aged around of 42 years, undergoing upper jawbone (74%) endodontic procedure. NaOCl concentration ranged from 1% to 10%, with 0.5 to 30 mL injected. Most cases (86%) corresponded to an accidental extrusion beyond the root apex to the periapical tissues, followed by tissular injection by error (8%) and extrusion into the maxillary sinus (3%). Local symptoms always occurred within 24 h, mostly pain (99%), edema (89%) and/or ecchymosis (61%). Complications were mainly neurological (29%), necrotic (22%) and cutaneous (9%). Most of patients (76%) fully recovered after medical management but 18 (24%) required surgical management.ConclusionAny healthcare professional should be aware of the classical symptomatic triad of NaOCl accident with sudden pain, haemorrhage/ecchymosis and swelling, to start or recommend adequate management. Patients should be reassured, but a close follow‐up is necessary to avoid delayed complication.

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Section: Resultsmentioning

confidence: 99%