Abstract:

Sodium hypochloride (NaOCl) is the most commonly used irrigation solution in endodontic application. Although NaOCl has strong antimicrobial and organic tissue solvent properties, it is quite cytotoxic when stumbling from periapic tissues. When this solution is extracted into neighboring tissues, the patient usually experiences sudden and intense pain and urgent treatment should be applied to prevent the formation of long-term seeds. This report describes the case of NaOCl’s accidental extraction from apical foolus during endodontic treatment. A 15-year-old woman with irreversible pulpitis diagnosis was directed for endodontic treatment in the top right first big minor tooth. During the root channel irrigation with 5.25% NaOCl, the patient suddenly felt severe pain. It was seen that the patient had a clear swelling on the face and a intense bleeding came from the palatinal canal to fill the pulp room as well. When forming was completed, calcium hydroxide drugs were placed in the root channels, antibiotics were prescribed. But because the patient did not use antibiotics, the 3rd day table advanced and turned into the form of ecymosis and cellulite. The management of the condition was carried out with the patient's biochemical examinations, tomography and intravenous antibiotics and steroid treatment. After 7 days the swelling completely disappeared and the symptoms passed, the treatment of the related tooth canal was completed. Clinical and radiographic trials conducted 6 months and 1 year later showed that the tooth was asymptomatic and healthy. This case report also details the measures that can be taken to reduce the risk of NaOCl transfer and to manage the potential serious complications.

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