Guidelines for management of sodium hypochlorite extrusion injuries

Abstract

Sodium hypochlorite (NaOCl) is the most common irrigant used in modern endodontics. It is highly effective at dissolving organic debris and disinfecting the root canal system due to the high pH. Extravasation of NaOCl into intra-oral and extra-oral tissues can lead to devastating outcomes leading to long-term functional and aesthetic deficits. Currently no clear guidelines are available which has caused confusion among the dental and oral and maxillofacial (OMFS) surgical community how best to manage these patients. Following a literature review and considering our own experience we have formulated clear and precise guidelines to manage patients with NaOCl injury.

Cytotoxicity of peracetic acid: evaluation of effects on metabolism, structure and cell death

“…In addition, NaOCl is highly irritating when in contact with periapical tissues (Farook et al . ). Currently, the alternate use of NaOCl and ethylenediaminetetraacetic acid (EDTA) irrigants is recommended to remove both the inorganic and organic components of the smear layer (Violich & Chandler ).…”

Penetration of sodium hypochlorite into root canal dentine: effect of surfactants, gel form and passive ultrasonic irrigation

“…), it is irritating when extruded into periapical tissues at high concentrations (Farook et al . ) and has a pronounced negative effect on the survival and differentiation of stem cells of the apical papilla, factors that may hinder periapical repair and pulpal regeneration (Martin et al . ).…”

Predictive Factors of Gastrointestinal Injuries after Exposure to Sodium Hypochlorite

“…So sodium hypochlorite is a potent oxidizer and exhibit antimicrobial or pathogen activity [13]. NaOCl is the frequently used as a disinfectant and an active ingredient in household bleach due to its alkaline nature [14,15]. Household bleach is a solutions containing 1-6% of NaOCl [15].…”