Article

Anatomy of sodium hypochlorite accidents.

Division of Endodontics, University of Colorado, School of Dental Medicine, Aurora, USA.
Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995) 11/2007; 28(10):544-6, 548, 550.
Source: PubMed

ABSTRACT Sodium hypochlorite (NaOCl) in various concentrations is the most widely used endodontic irrigant, but it can be an irritant to vital tissues. There are several reports about the complications of irrigation with NaOCl during root canal therapy. 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. This article is a review and comparison of all reported NaOCl accidents in the literature.

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    • "Sodium hypochlorite (NaOCl) is a commonly used irrigant in root canal treatment offering disinfection and debris removal because of its effective ability to dissolve organic soft tissue because of its powerful oxidation ability (Mentz 1982, Ayhan et al. 1999, Mehdipour et al. 2007). The disadvantage of NaOCl is that it can cause acute inflammation followed doi:10.1111/j.1365-2591.2011.02009.x "
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    ABSTRACT: To show the radiographic manifestation of sodium hypochlorite after accidental injection past the apical foramen and into the soft tissues. A female patient was seen for an emergency visit after suffering a sodium hypochlorite accident at her general dentist's office. The patient was seen within 1 h of the accident and was in pain associated with facial swelling. Radiographs, including a Cone Beam Computed Tomography (CBCT), and photographs were taken. Endodontic emergency treatment was initiated. The patient was reassured and given pain medication and antibiotics. Follow-up visits were scheduled over 6 days when the swelling had resolved. • Importance of multiple radiographic images during preoperative endodontic evaluation when undertaking endodontic retreatment. • Knowledge of apical anatomy as related to surrounding structures. • Effect of sodium hypochlorite when injected in the soft tissues.
    International Endodontic Journal 01/2012; 45(5):492-8. DOI:10.1111/j.1365-2591.2011.02009.x · 2.27 Impact Factor
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    ABSTRACT: 09E01561 Irigasi merupakan bagian penting dari proses pembersihan pada perawatan saluran akar. Ada berbagai jenis larutan irigasi yang terbagi dalam tiga golongan besar yaitu golongan halogen, golongan detergen dan golongan chelating agent. Suatu bahan irigasi yang baik harus mampu melarutkan jaringan organik dan anorganik, melancarkan alat endodontik, bersifat antimikroba serta mempunyai efek toksisitas yang rendah. Sodium hypochlorite menjadi pilihan dalam mengirigasi saluran akar karena mekanisme kerja antimikroba yang efektif dalam mengurangi jumlah bakteri dalam saluran akar. Mekanisme kerja sodium hypochlorite terdiri dari 3 reaksi, yaitu reaksi saponifikasi, reaksi netralisasi dan reaksi kloraminisasi. Namun, sodium hypochlorite juga mempunyai efek toksik pada jaringan vital apabila digunakan dalam konsentrasi setinggi 5.25%. Oleh hal demikian, konsentrasi sodium hypochlorite 1% adalah lebih biokompatibel pada jaringan vital tubuh. Efek toksik sodium hypochlorite sangat dipengaruhi oleh konsentrasi larutan, pH, serta lama waktu larutan sodium hypochlorite bereaksi dengan jaringan vital. Penyemprotan larutan sodium hypochlorite kearah jaringan periapikal dapat menyebabkan rasa sakit,ulserasi,hemolisis, odema serta pembengkakan.Oleh karena itu, perawatan yang baik dan adekuat harus diberikan untuk mencegah terjadi infeksi sekunder. Pencegahan toksisitas dapat dilakukan dengan preparasi saluran akar yang adekuat, penentuan panjang kerja yang baik serta menguasai teknik irigasi yang benar. Sitti Chadidjah Az, drg
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