Most of the complications are the result of accidental extrusion of the solution from. Early recognition of this problem and prompt management may reduce further complications. Sodium hypochlorite is generally not utilized in its most active form in a clinical setting. Sodium hypochlorite naocl, the most commonly used irrigant in endodontics, is known to produce allergic reactions. The main causative factors responsible for the occurrence of endodontic emergencies are mainly pulp and periradicularpathosis, traumatic injuries, procedural complications etc, among which sodium hypochlorite accidents can occur. Sodium hypochlorite extrusion can cause facial nerve weakness in addition to other soft tissue damage. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue. Sodium hypochlorite and its use as an endodontic irrigant. Contents introduction root canal bacterium root canal irrigants ideal requirements of a root canal irrigant natural occurrence of naocl history of naocl chemistry of naocl mode of action suggested irrigation regimen efficacy. Sodium hypochlorite irrigation and its effect on bond. This is most likely to occur through the apical foramen of a tooth, but can also occur through a perforation or resorptive defect. Sodium hypochlorite is a chlorine compound often used as a disinfectant or a bleaching agent. Inadvertent extrusion of sodium hypochlorite during endodontic. Contents introduction root canal bacterium root canal irrigants ideal requirements of a root canal irrigant natural occurrence of naocl history of naocl chemistry of naocl mode of action suggested irrigation regimen efficacy time factor.
Sodium hypochlorite is a commonly used irrigant in endodontic practice. This file may not be suitable for users of assistive technology. The anhydrous compound is unstable and may decompose explosively. At 1% concentration, sodium hypochlorite presents a surface tension equal to 75 dynescm, stickiness equal to 0.
Atbaseline and at 2 wk,the study patients received professional subgingival irrigation for 5 min with either 0. Use of vital pulp therapies in primary teeth with deep caries. Dec 19, 2014 sodium hypochlorite naocl is the most common irrigant used in modern endodontics. It appears that the usage guidelines recommend since several years are still adequate in 2017. Sodium hypochlorite accidentally extruded beyond the. Effects of sodium hypochlorite as dentin deproteinizing. Properties of sodium hypochlorite naocl as an irrigant in root canal therapy. Studies have showed that naocl is biological compatible and is a very good antimicrobial solution without being a. There are several reports about the complications of irrigation with naocl during root canal therapy. Such variation in bonding systems chemistries was related to the ability of their etchants to remove the degenerated dentin, produced by acid etching, as well as the residual naocl, that would interfere with the free radical polymerization reaction of resin cement, from. Sodium hypochlorite naocl has an extensive history in medicine and dentistry and continues to be popular even today. Bleaching powder or hypochlorite solution mostly used disinfectant for hiv infected material.
This fact, however, is rarely mentioned in endodontic texts. Sodium hypochlorite naocl in various concentrations is the most widely used endodontic irrigant, but it can be an irritant to vital tissues. Studies have showed that naocl is biological compatible and is a very good antimicrobial solution without being a pulpal irritant. Chlorine and sodium hypochlorite hazards and risks. It has a role as a disinfectant and a bleaching agent. Because of its antimicrobial activity, low viscosity, ability to dissolve the tissues, lubrication action and availability it is considered to be the most frequently used endodontic irrigant 27 therefore. References clarkson rm, moule aj 1998 sodium hypochlorite and its use as an endodontic irrigant. It has many potential complications ranging from permanent bleaching of clothes to severe soft tissue damage. If sodium hypochlorite is swallowed, call a doctor or poison control center right away. According to clorox, undiluted household bleach has a shelf life of six. Inadvertent extrusion of sodium hypochlorite during. If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
Sodium hypochlorite hypochlorite accident inadvertent extrusion root canal irrigant. Sodium hypochlorite prefilled syringes vista dental. Dentistry and endodontics, department of oral rehabilitation, school of oral health. Sodium hypochlorite is a greenishyellow liquid commonly referred to as bleach. Sodium hypochlorite naocl product material safety data. Use of vpt on primary teeth e147 e146 us6of41vu6pustffffnfrif mfvafyfffffp1efmfaouffh or formocresol. Significant rightsided facial swelling, bruising and pain were present. Sodium hypochlorite household bleach is the most commonly used root canal irrigant. Do not use 2 doses at the same time or extra doses. Context chlorine and sodium hypochlorite are widely used for disinfection and bleaching, among other things to disinfect drinking water.
It is available in different concentrations ranging from 5% to 10%. It is a broadspectrum disinfectant that is effective for the disinfection of viruses, bacteria, fungi, and mycobacterium. Sodium hypochlorite produced by a continuous process will have approximately 0. Any product strength below 7% is not regulated by tdg. Mar, 2015 a sodium hypochlorite accident is the inadvertent extrusion of sodium hypochlorite solution into the periradicular tissues of a tooth undergoing endodontic treatment. Sodium hypochlorite appears as colorless or slightly yellow watery liquid with an odor of household bleach. Abstract this study evaluated the effect of 10% sodium hypochlorite naocl as deproteinizing agent and storage media on bond strength bs of two. Chances of sodium hypochlorite accidents are more in buccal and. The root canals are debrided and shaped with hand or rotary files. Sodium hypochlorite naocl uses, indications and complications. Sodium hypochlorite, an excellent nonspecific proteolytic and antimicrobial agent, is the most common irrigation solution used during root canal therapy.
Aqueous sodium hypochlorite bleach solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue. Material safety data sheet sodium hypochlorite 320%. As observed the effect of sodium hypochlorite on dentin bonding varies with chemistries of the bonding systems. During world war i, the chemist henry drysdale dakin and the surgeon alexis carrel extended the use of buffered 0.
A sodium hypochlorite accident occurred in a pediatric. You will need to talk about the benefits and risks of using sodium hypochlorite while you are pregnant. Sodium hypochlorite naocl is the most common irrigant used in modern endodontics. Its accident is uncommon to be encountered in the dental clinic. Although it is considered to be safe, serious mishap can result from its inappropriate use, and this has been reported infrequently in the literature. The advantages of sodium hypochlorite are its low cost, its effectiveness, and its safety. Dds graduate, national school of dentistry, national university of mexico unam. If sodium hypochlorite solutions are selected use a 1. A 66yearold female patient presented to the accident and emergency department, 3 h following a dental appointment. Inadvertent apical extrusion of sodium hypochlorite with. Use of sodium hypochlorite in root canal irrigation. Loss of working length, active irrigation, open apex, fractured root, perforation, presence of lateral canals and fenestration may contribute to extrusion of sodium hypochlorite into periradicular area 17. Risks and management of sodium hypochlorite in endodontics. When used on wounds, dakins solution can be poured onto the affected area as an irrigation or cleanser.
Sodium hypochlorite is an inorganic sodium salt in which hypochlorite is the counterion. A selfreporting questionnaire was distributed to academic, governmental, and private dental centers in riyadh, saudi arabia. Clorox regular bleach was the source of the sodium hypochlorite. Introduction root canal treatment aims to the complete removal of the connective tissue and the destruction of residual microorganisms found in infected root canals. Sodium hypochlorite naocl was initially reported as an effective endodontic irrigant in 1920 1. Sodium hypochlorite is used to irrigate root canals in dentistry and can cause many adverse reactions seda34, 380. The presence of transition metal ions copper and nickel is known to catalyze the decomposition of liquid sodium hypochlorite, contributing to the loss of bleach strength. While working with sodium hypochlorite, safety measures have to be taken to protect workers and the environment. Neurological complications following extrusion of sodium. Hypochlorite sodium an overview sciencedirect topics. Sodium hypochlorite, commonly known as bleach, is most frequently used as a disinfecting agent. Pulp therapy for primary and immature permanent teeth aapd.
Guidelines for management of sodium hypochlorite extrusion. If chemicals andor deep caries andor the overheating of a tooth during the cutting of a crown lead to the dying off of the dental nerve, the nerve must be removed and the hollow root canal must be sealed. Complications following an accidental sodium hypochlorite. Sodium hypochlorite is widely used in dentistry as an intracanal irrigant, for debridement and to disinfect root canals. Irrigation material is a very important part of the procedure as it helps in killing and disinfecting the root canal along with removing the debris from the canal. In dentistry, sodium hypochlorite naocl is used to rinse root canals during root canal treatments. In addition, it seeks an effective seal in order to prevent recoloniza. Sodium hypochlorite prefilled syringes vista dental products. Sodium hypochlorite use, storage, and delivery methods. The aim of this article is to provide the dental practitioner about the potential inadvertent effects of sodium hypochlorite and its management on. A sodium hypochlorite accident is the inadvertent extrusion of sodium hypochlorite solution into the periradicular tissues of a tooth undergoing endodontic treatment.
Colleagues excellence american association of endodontists. For proper antimicrobial activity, it must be prepared freshly just before its use. A 56yearold female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. Sodium hypochlorite sodium hypochlorite is both an oxidizing and hydrolyzing agent. Sodium hypochlorite should not come in contact with air, because that will cause it to disintegrate. This is a faithful synthesis and summary of several scientific consensus reports. Complications following an accidental sodium hypochlorite extrusion. Sodium hypochlorite is known to be corrosive to metals, therefore, it important to wipe down metal surfaces with water or ethanol after treating them with a bleach solution. Many times sodium hypochlorite is used on an as needed basis. Sodium hypochlorite is a dangerous and corrosive substance. This case report describes the tissue injury caused by inadvertently extruded naocl through the apical constriction.
Km 32 mcarthur highway, guiguinto, bulacan 3015 6344794044445 180018886800 63447944104 2. The patient had been sent by her general dental practitioner with a covering letter explaining that a hypochlorite accident had occurred during root canal treatment of the upper. When used on wounds, dakins solution can be poured onto the. Although sodium hypochlorite is more frequently used as endodontic irrigant. May 14, 2014 sodium hypochlorite naocl has been used in root canal irrigant for more than 80 years, and it is at present the most popular irrigant in root canal treatment. Aqueous, sodium hypochlorite solution from vista dental is used for irrigation, debridement and disinfection of root canals during and after instrumentation. It may also be viewed as the sodium salt of hypochlorous acid.
Phe publications gateway number 2014790 pdf, 214kb, 10 pages. Sodium hypochlorite solutions have been used as wound irrigants since at least 1915,4 and as an endodontic irrigant as early as 1920. If you use sodium hypochlorite on a regular basis, use a missed dose as soon as you think about it. Sodium hypochlorite naocl has been used in root canal irrigant for more than 80 years, and it is at present the most popular irrigant in root canal treatment.
May 12, 2007 sodium hypochlorite is a commonly used irrigant in endodontic practice. Endodontic emergency is a condition associated with pain, swelling which require immediate diagnosis and treatment. Prefilled syringes packaged with applivac 27 ga irrigating tips. The aim of this study is to investigate sodium hypochlorite naocl delivery and storage methods by general dental practitioners gdps and specialists. Sodium hypochlorite an overview sciencedirect topics. Lachenmeier, in side effects of drugs annual, 2015. Although it is generally regarded as being very safe.
1052 1187 122 89 722 1485 348 1128 1649 519 1498 552 867 911 828 1382 1602 341 257 219 998 395 321 1566 806 234 642 543 1286 146 1358 1279 809 1600 1376 8 359 1106 495 1319 901