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Sodium hypochlorite accident resulting in life-threatening airway obstruction during root canal treatment: a case report

Authors Al-Sebaei M, Halabi O, El-Hakim I

Received 17 December 2014

Accepted for publication 24 January 2015

Published 4 March 2015 Volume 2015:7 Pages 41—44


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Christopher E. Okunseri

Maisa O Al-Sebaei,1 Omar A Halabi,2 Ibrahim E El-Hakim3

1Department of Oral and Maxillofacial Surgery, King Abdulaziz University – Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia; 2Saudi Board of Oral and Maxillofacial Surgery, Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia; 3Department of Oral and Maxillofacial Surgery, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Kingdom of Saudi Arabia

Aim: This case report describes a serious and life-threatening complication of the use of sodium hypochlorite as an irrigation solution in root canal therapy.
Summary: This case report describes a hypochlorite accident that occurred in a healthy 42-year-old female who was undergoing routine root canal therapy for the lower right central incisor (tooth #41). After approximately 1 hour of irrigation with 3% sodium hypochlorite (for a total of 12 cc), the patient complained of severe pain and burning in the lip. The swelling progressed over the next 8 hours to involve the sublingual and submental fascial spaces with elevation of the tongue and resultant upper airway obstruction. The patient was intubated and remained on mechanical ventilation for 3 days. She recovered without any skin necrosis or nerve deficits.
Key learning points: This case report highlights the importance of carefully performing root canal irrigation with sodium hypochlorite to avoid complications. Careful injection without pressure, the use of proper rubber dam isolation, and the use of the endodontic needle are necessary to avoid this type of complication. Although it is a safe root canal irrigation solution, its use may lead to life-threatening complications. Early recognition and management of the untoward effects of sodium hypochlorite are vital for the patient's safety.

Keywords: complications of root canal, facial edema, root canal irrigation, root canal therapy, sodium hypochlorite, upper airway obstruction

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