Ortiz-Alves Tatiana, Díaz-Sánchez RosaRosa, Gutiérrez-Pérez José-Luis, González-Martín Maribel, Serrera-Figallo María-Ángeles, Torres-Lagares Daniel
Master in Oral Surgery - Dentistry Department, Dentistry Faculty, University of Seville, Seville, Spain.
Master Chief of Oral Surgery- Dentistry Department, University of Seville, Seville, Spain.
J Clin Exp Dent. 2022 Oct 1;14(10):e885-e889. doi: 10.4317/jced.59862. eCollection 2022 Oct.
Sodium hypochlorite is the most used irrigant in endodontics, although its toxic effect on tissue is known. Sodium hypochlorite extrusion to periapical tissue can cause complications of varying severity, from oedemas and haemorrhagic lesions to life-threatening ones due to airway compromise. Our patient attended the Oral and Maxillofacial Surgery department of the Virgen del Rocío University Hospital and was referred by his dentist after bone exposure as a result of irrigant extrusion during endodontics on tooth 14. Sodium hypochlorite caused significant bone and mucosal tissue necrosis to teeth 13-16, with communication to the maxillary sinus. Several surgical procedures were needed to perform the correct debridement of the necrotic tissue and obtain good mucous. Precautions need to be taken during the use of NaOCl to avoid spreading to surrounding tissue. In cases with open apexes and apical lesion, the use of safer irrigants should be considered as an alternative. Sodium hypochlorite, extrusion, complication, bone necrosis.
次氯酸钠是牙髓病治疗中使用最广泛的冲洗剂，尽管其对组织的毒性作用是已知的。次氯酸钠渗入根尖周组织可导致不同严重程度的并发症，从水肿和出血性病变到因气道受压而危及生命的病变。我们的患者前往罗西奥圣母大学医院口腔颌面外科就诊，他在对14号牙进行牙髓病治疗期间因冲洗剂渗入导致骨质暴露，随后被牙医转诊至此。次氯酸钠导致13 - 16号牙的骨质和黏膜组织严重坏死，并与上颌窦相通。需要进行多次外科手术以正确清除坏死组织并获得良好的黏膜状况。在使用次氯酸钠时需要采取预防措施，以避免扩散到周围组织。对于根尖开放和根尖病变的病例，应考虑使用更安全的冲洗剂作为替代。次氯酸钠、渗入、并发症、骨质坏死。
