Sodium Hypochlorite Irrigation Extrusion in Root Canal Treatment: An Updated Overview

Abstract

Effective endodontic treatment requires the proper choice of instruments and irrigation techniques in chemo-mechanical preparation. Sodium hypochlorite (NaOCl) is the most employed irrigant in endodontic practice, known for its efficiency in disinfecting the root canal system and dissolving organic debris. However, its cytotoxicity poses a drawback, potentially causing acute harm when extruded beyond the apex, a situation referred to as a NaOCl accident. While this occurrence is rare globally, NaOCl extrusion during root canal therapy can lead to severe aftereffects in addition to acute symptoms like pain and swelling. This review paper aims to guide dental clinicians in the early detection and diagnosis of NaOCl accidents, providing appropriate management strategies. The discussion encompasses the prevalence, risk factors, management, complications, and prognosis of NaOCl extrusion beyond the root apex. Recommendations and preventive measures for safely using sodium hypochlorite irrigation during endodontic therapy are also highlighted to ensure better management of hypochlorite accident symptomatology.