Complications Caused by Apical Extrusion of Sodium Hypochlorite. A Case Report Study and Systematic Review

Abstract

AIM: Sodium hypochlorite (NaOCl) is widely used as an irrigant during root canal treatments due to its potent antimicrobial properties. However, its inadvertent apical extrusion can lead to significant complications. This study aims to assess the safety and efficacy of NaOCl as an irrigant in endodontic procedures and analyze the risks associated with its apical extrusion. METHODS: A systematic review and case report study were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed in the Web of Science, Scopus, and PubMed databases, limited to articles published in English between 2004 and 2024. RESULTS: The initial search identified 724 articles, with 267 remaining after the removal of duplicates. Following the application of inclusion criteria, 9 studies were selected for final analysis. CONCLUSIONS: While NaOCl remains the gold standard for root canal irrigation, improper handling can result in severe complications, including chemical burns and tissue necrosis. The study highlights the importance of implementing safety measures such as accurate irrigation techniques, the use of rubber dams, and side-exit needles to minimize risks. Further research is necessary to refine irrigation protocols and enhance patient safety, emphasizing the need for collaboration among dental professionals for optimal treatment outcomes.