Clinical consequences and behaviors in relation to accidents concerning extravasation of NaClO in endodontics

Abstract

Endodontic therapy predicts the chemical-mechanical decontamination of the root canals sodium hypochlorite (NaClO) being the most commonly used chemical. A critical review of the literature on the consequences of accidentsby extravasation of NaClO during endodontic treatments and clinical necessary procedures in such cases. We searched the Scielo and Lilacs databases with descriptors in Portuguese and in the PubMed database with descriptors in English, being obtained 98 articles records available for complete reading, published between 2003-2018. Those whose subjects answered the questions in discussion were included: HClO as an endodontic irrigator; factors that affect the extrusion of hypochlorite in endodontic treatments, consequences and clinical management in case of extravasation of the irrigant. The extrusion of hypochlorite beyond the apical foramen leads to tissue destruction and necrosis. However, there are few studies with recommendations after accidents due to extravasation of NaClO in the endodontic clinic. In cases of accidents, the substance should be aspirated and the area washed with sterile saline. There is no single protocol for intervention, the extent and severity of the accident must be assessed. The priority is pain relief, edema control and prevention of secondary infections. The professional must take into account the daily possibility of accidents and take preventive measures.