Skip to main content
SpringerLink
Log in

Complications Due to Medicaments

  • Chapter
  • First Online:
Common Complications in Endodontics

  • 1550 Accesses

Abstract

Medicament uses in root canal system are of so many varieties and have effects on both pulpal tissues and microbial flora not just inside the root canal system but the periodontium as well. That is why when choosing any medicament, the clinician must make the right choice. Choose a medicament which has an effect on the microorganisms, as this is the most important factor in root canal failures and it should have the least effect on the tissues surrounding the root. The medicament should be confined in the root canal system during its use, and care should be taken not to expel it beyond the root apex into the periapical tissues. In case this happens, damage to the periapical tissues ensues leading to inflammation, swelling and probably tooth loss.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Peters OA, Laib A, Gohring TN, Barbakow F. Changes in root canal geometry after preparation assessed by high-resolution computed tomography. J Endod. 2001;27:1–6.

    PubMed  Google Scholar 

  2. Zehnder M. Root canal irrigants. J Endod. 2006;32:389–98.

    PubMed  Google Scholar 

  3. Harrison JW. Irrigation of the root canal system. Den Clinics North Am. 1984;28:797–808.

    Google Scholar 

  4. FPV F. Accidents with sodium hypochlorite in endodontics: a literature review of clinical cases. Dental Press Endod. 2014;4(3):57–70.

    Google Scholar 

  5. Spencer HR, Ike V, Brennan PA. Review: the use of sodium hypochlorite in endodontics- potential complications and their management. Br Dent J. 2007;202:555–9.

    PubMed  Google Scholar 

  6. Hülsmann M, Hahn W. Complications during root canal irrigation—literature review and case reports. Int Endod J. 2000;33:186–93.

    PubMed  Google Scholar 

  7. Pashley EL, Birdsong NL, Bowman K, et al. Cytotoxic effects of NaOCl on vital tissue. J Endod. 1985;11:525–8.

    PubMed  Google Scholar 

  8. Guivarc’h M, et al. Sodium hypochlorite accident: a systematic review. JOE. 2017;43(1):16–24.

    PubMed  Google Scholar 

  9. Bowden JR, Ethunandan M, Brennan PA. Life-threatening airway obstruction secondary to hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:402–4.

    PubMed  Google Scholar 

  10. Al-Sebaei MO, Halabi OA, El-Hakim IE. Sodium hypochlorite accident resulting in life-threatening airway obstruction during root canal treatment: a case report. Clin Cosmet Investig Dent. 2015;7:41–4.

    PubMed  PubMed Central  Google Scholar 

  11. Balto H, Al-Nazhan S. Accidental injection of sodium hypochlorite beyond the root apex. Saudi Dent J. 2002;14:36–8.

    Google Scholar 

  12. de Sermeño RF, da Silva LA, Herrera H, et al. Tissue damage after sodium hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:46–9.

    Google Scholar 

  13. Tegginmani VS, Chawla V, Kahate MM, et al. Hypochlorite accident—a case report. Endodontology. 2011;23:89–94.

    Google Scholar 

  14. Farook SA, Shah V, Lenouvel D, Sheikh O, Sadiq Z, Cascarini L. Guidelines for management of sodium hypochlorite extrusion injuries. Br Dent J. 2014;217:679–84.

    PubMed  Google Scholar 

  15. Mehdipour O, Kleier DJ, Averbach RE. Anatomy of sodium hypochlorite accidents. Compend Contin Educ Dentist. 2007;28:544–6.

    Google Scholar 

  16. Lloyd RE. Surgical emphysema as a complication in endodontics. Br Dent J. 1975;138:393.

    PubMed  Google Scholar 

  17. Snyder MD, Rosenberg ES. Subcutaneous emphysema during periodontal surgery: report of a case. J Periodontol. 1977;48:790–1.

    PubMed  Google Scholar 

  18. Rhymes R. Post extraction subcutaneous emphysema. Oral Surg. 1964;17:271–3.

    PubMed  Google Scholar 

  19. Hayduk S, Bennett CR, Monheim LM. Subcutaneous emphysema after operative dentistry: report of a case. J Am Dent Assoc. 1970;80:1362.

    PubMed  Google Scholar 

  20. Battrum DE, Gutmann JL. Implications, prevention and management of subcutaneous emphysema during endodontic treatment. Endod Dent Traumatol. 1995;11:109–14.

    PubMed  Google Scholar 

  21. Lindsey B. Oxford concise medical dictionary. 6th ed. Oxford, UK: Oxford University Press; 2003.

    Google Scholar 

  22. Noordzji JP, Wambach BA, Josephson GD. Subcutaneous cervicofacial and mediastinal emphysema after dental instrumentation. Otolaryngol Head Neck Surg. 2001;124:170–1.

    PubMed  Google Scholar 

  23. Fruhauf J, Weinke R, Pilger U, Kerl H, Mullegger RR. Soft tissue cervicofacial emphysema after dental treatment. Arch Dermatol. 2005;141:1437–40.

    PubMed  Google Scholar 

  24. Smatt Y, Browaeys H, Genay A, Raoul G, Ferri J. Iatrogenic pneumomediastinum and facial emphysema after endodontic treatment. Br J Oral Maxillofac Surg. 2004;42:160–2.

    PubMed  Google Scholar 

  25. Lambrianidis TP. Emphysema. In: Lambrianidis T, editor. Risk management in root canal treatment. Thessaloniki: University Studio Press; 2001. p. 323–36.

    Google Scholar 

  26. Chen SC, Lin FY, Chang KJ. Subcutaneous emphysema and pneumomediastinum after dental extraction. Am J Emerg Med. 1999;17:678–80.

    PubMed  Google Scholar 

  27. Josephson GD, Wambach BA, Noordzji JP. Subcutaneous cervicofacial and mediastinal emphysema after dental instrumentation. Otolaryngol Head Neck Surg. 2001;124:170–1.

    PubMed  Google Scholar 

  28. Shovelton DS. Surgical emphysema as a complication of dental operations. Br Dent J. 1957;102:125–9.

    Google Scholar 

  29. Rickles NH, Joshi BA. Death from air embolism during root canal therapy. J Am Dent Assoc. 1963;67:397–404.

    PubMed  Google Scholar 

  30. Eleazer PD, Eleazer KR. Air pressures developed beyond the apex from drying root canals with pressurized air. J Endod. 1998;24:833–6.

    PubMed  Google Scholar 

  31. Kaufman A. Facial emphysema caused by hydrogen peroxide irrigation: report of case. J Endod. 1981;7:470–2.

    PubMed  Google Scholar 

  32. Bhat K. Tissue emphysema caused by hydrogen peroxide. Oral Surg Oral Med Oral Pathol. 1974;38:304–8.

    PubMed  Google Scholar 

  33. Grossman LI. Endodontic practice. Philadelphia: Lea & Febiger; 1981. p. 243–5.

    Google Scholar 

  34. Seltzer S, Bender I. The dental pulp. Philadelphia: Lippincott; 1984. p. 218–9.

    Google Scholar 

  35. Steinberg D, Heling I, Daniel I, Ginsburg I. Antibacterial synergistic effect of chlorhexidine and hydrogen peroxide against Streptococcus Sobrinus, Streptococcus Faecalis, Staphylococcus aureus. J Oral Rehab. 1999;26:151–2.

    Google Scholar 

  36. Seal GJ, Ng L-Y, Spratt D, Bhatti M, Gulabivala K. An in vitro comparison of bacterial efficacy of lethal photosensitisation or sodium hypochlorite irrigation on Streptococcus Intermedius biofilms in root canals. Int Endodont J. 2002;35:268–74.

    Google Scholar 

  37. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, Kim J, Shabahang S. A new solution for the removal of the smear layer. J Endod. 2003;29:170–5.

    PubMed  Google Scholar 

  38. Hulsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endodont J. 2003;36:810–30.

    Google Scholar 

  39. Beltz RE, Torabinejad M, Pouresmail MV. Quantitative analysis of the solubilising action of MTAD, sodium hypochlorite and EDTA on bovine pulp and dentine. J Endod. 2003;29:334–7.

    PubMed  Google Scholar 

  40. Tamir MD, Backleh MD, Hamdan MD, Eliashar MD. Cervico-facial emphysema and pneumomediastinum complicating a high-speed drill dental procedure. IMA J. 2005;7:124–5.

    Google Scholar 

  41. Kim Y, Kim MR, Kim SJ. Iatrogenic pneumomediastinum with extensive subcutaneous emphysema after endodontic treatment: report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e114–9.

    PubMed  Google Scholar 

  42. Horowitz I, Hirshberg A, Freedman A. Pneumomediastinum and subcutaneous emphysema following surgical extraction of mandibular third molars: three case reports. Oral Surg Oral Med Oral Pathol. 1987;63:25–8.

    PubMed  Google Scholar 

  43. Heyman SN, Babayof I. Emphysematous complications in dentistry, 1960-1993: an illustrative case and review of the literature. Quintessence Int. 1995;26:535–43.

    PubMed  Google Scholar 

  44. Mishra L, Patnaik S, Patro S, Debnath N. Iatrogenic subcutaneous Emphysema of Endodontic origin—case report with literature review. J Clin Diagn Res. 2014;8(1):279–81.

    PubMed  PubMed Central  Google Scholar 

  45. Karras SC, Sexton JJ. Cervicofacial and mediastinal emphysema as the result of a dental procedure. J Emerg Med. 1996;14:9–13.

    PubMed  Google Scholar 

  46. Crincoli V, Scivetti M, Di Bisceglie MB, Pilolli GP, Gianfranco FG. Unusual case of adverse reaction in the use of sodium hypochlorite during endodontic treatment: a case report. Quintessence Int. 2008;39:e70–3.

    PubMed  Google Scholar 

  47. Kost M. Thoracic complications associated with utilization of the air turbine dental drill. AANA J. 1996;64:288–92.

    PubMed  Google Scholar 

  48. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340–9.

    PubMed  Google Scholar 

  49. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res. 1981;89:321–8.

    PubMed  Google Scholar 

  50. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30:559–67.

    PubMed  Google Scholar 

  51. Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endod Dent Traumatol. 1990;6:142–9.

    PubMed  Google Scholar 

  52. Peters LB, Wesselink PR. Combinations of bacterial species in endodontic infections. Int Endod J. 2002;35:698–702.

    PubMed  Google Scholar 

  53. Gomes BPFA, Ferraz CCR, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of enterococcus faecalis. Int Endod J. 2001;34:424–8. PubMed: 11556507

    PubMed  Google Scholar 

  54. Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. J Endod. 1998;24:472–6. PubMed: 9693573

    PubMed  Google Scholar 

  55. Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CC, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radio Endod. 2004;97:79–84.

    Google Scholar 

  56. Ehrich DG, Brian JD, Walker WA. Sodium hypochlorite accident: inadvertent injection into the maxillary sinus. J Endod. 1993;19:180–2. PubMed: 8326264

    PubMed  Google Scholar 

  57. Jeansonne MJ, White RR. A comparison of 2.0% chlorhexidine gluconate and 5. 25% sodium hypochlorite as antimicrobial endodontic irrigants. J Endod. 1994;20:276–8. PubMed: 7931023

    PubMed  Google Scholar 

  58. Oncag O, Hosgor M, Hilmioglu S, Zekioglu O, Eronat C, Burhanoglu D. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J. 2003;36:423–32. PubMed: 12801290

    PubMed  Google Scholar 

  59. Ohara P, Torabinejad M, Kettering JD. Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria. Endod Dent Traumatol. 1993;9:95–100. PubMed: 8243347

    PubMed  Google Scholar 

  60. Delaney GM, Patterson SS, Miller CH, Newton CW. The effect of chlorhexidine gluconate irrigation on the root canal flora of freshly extracted necrotic teeth. Oral Surg Oral Med Oral Pathol. 1982;53:518–23. PubMed: 6954427

    Google Scholar 

  61. White RR, Hays GL, Janer LR. Residual antimicrobial activity after canal irrigation with chlorhexidine. J Endod. 1997;23:229–31. PubMed: 9594771

    PubMed  Google Scholar 

  62. Rosenthal S, Spangberg L, Safavi K. Chlorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radio Endod. 2004;98:488–92.

    Google Scholar 

  63. Komorowski R, Grad H, Wu XY, Friedman S. Antimicrobial substantivity of chlorhexidinetreated bovine root dentin. J Endod. 2000;26:315–7. PubMed: 11199744

    PubMed  Google Scholar 

  64. Vivacqua-Gomes N, Ferraz CC, Gomes BP, Zaia AA, Teixeira FB, Souza-Filho FJ. Influence of irrigants on the coronal microleakage of laterally condensed guttapercha root fillings. Int Endod J. 2002;35:791–5.

    PubMed  Google Scholar 

  65. Basrani BR, Manek S, Sodhi RNS, Fillery E, Manzur A. Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod. 2007;33:966–9. PubMed: 17878084

    PubMed  Google Scholar 

  66. Burkhardt-Holm P, Oulmi Y, Schroeder A, Storch V, Braunbeck T. Toxicity of 4-chloraniline in early life stages of Zebrafish (Danio Rerio): II. Cytopathology and regeneration of liver and gills after prolonged exposure to waterborne 4 chloraniline. Arch Environ Contam Toxicol. 1999;37:85–102. PubMed: 10341046

    PubMed  Google Scholar 

  67. Chhabra RS, Huff JE, Haseman JK, Elwell MR, Peters AC. Carcinogenicity of p-chloroaniline in rats and mice. Food Chem Toxicol. 1991;29:119–24.

    PubMed  Google Scholar 

  68. Krishnamurthy S, Sudhakaran S. Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine. J Endod. 2010;36(7):1154–7.

    PubMed  Google Scholar 

  69. Sjogren U, Figdor D, Spangberg L, Sundqvist G. The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J. 1991;24:119–25.

    PubMed  Google Scholar 

  70. Hauman CH, Love RM. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 1. Intracanal drugs and substances. Int Endod J. 2003;36:75–85.

    PubMed  Google Scholar 

  71. De Moor RJ, De Witte AM. Periapical lesions accidentally filled with calcium hydroxide. Int Endod J. 2002;35:946–58.

    PubMed  Google Scholar 

  72. Alacam T, Gorgul G, Omurlu H. Evaluation of diagnostic radiopaque contrast materials used with calcium hydroxide. J Endod. 1990;16:365–8.

    PubMed  Google Scholar 

  73. Smith GN, Woods S. Organic iodine: a substitute for BaSO4 in apexification procedures. J Endod. 1983;9:153–5.

    PubMed  Google Scholar 

  74. Trope M, Chivian N, Sigurdsson A, Vann WF Jr. Traumatic injuries. In: Cohen S, Burns RC, editors. Pathways of the pulp. 8th ed. St. Louis, MO: Mosby, Inc.; 2002. p. 603–49.

    Google Scholar 

  75. AHR R. Damage to the inferior dental nerve during or following endodontic treatment. Br Dent J. 1983;153:306–7.

    Google Scholar 

  76. Ørstavik D, Brodin P, Aas E. Paraesthesia following endodontic treatment: survey of the literature and report of a case. Int Endod J. 1983;16:167–72.

    PubMed  Google Scholar 

  77. Vernieks AA, Messer LB. Calcium hydroxide induced healing of periapical lesions: a study of 78 non-vital teeth. J Br Endod Soc. 1978;11:61–9.

    PubMed  Google Scholar 

  78. Lindgren P, Eriksson KF, Ringberg A. Severe facial ischemia after endodontic treatment. J Oral Maxillofac Surg. 2002;60(5):576–9.

    PubMed  Google Scholar 

  79. Brodin P, Ørstavik D. Effects of therapeutic and pulp protecting materials on nerve transmission in vitro. Scand J Dent Res. 1982;91:46–50.

    Google Scholar 

  80. Boiesen J, Brodin P. Neurotoxic effect of two root canal sealers with calcium hydroxide on rat phrenic nerve in vitro. Endod Dent Traumatol. 1991;7:242–5.

    PubMed  Google Scholar 

  81. Serper A, Üçer O, Onur R, Etikan I. Comparative neurotoxic effects of root canal filling materials on rat sciatic nerve. J Endod. 1998;24(9):592–4.

    PubMed  Google Scholar 

  82. Foreman PC, Barnes IE. A review of calcium hydroxide. Int Endod J. 1990;23:283–97.

    PubMed  Google Scholar 

  83. Maalouf EM, Gutmann JL. Biological perspectives on the nonsurgical endodontic management of periradicular pathosis. Int Endod J. 1994;27:154–62.

    PubMed  Google Scholar 

  84. De Bruyne MAA, De Moor RJG, Raes FM. Necrosis of the gingiva caused by calcium hydroxide: a case report. Int Endod J. 2000;33:67–71.

    PubMed  Google Scholar 

  85. Wilson A. Severe tissue necrosis following intra-arterial injection of endodontic calcium hydroxide: a case series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):666–9.

    PubMed  Google Scholar 

  86. Ahlgren FK, Johannessen AC, Hellem S. Displaced calcium hydroxide paste causing inferior alveolar nerve paraesthesia: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(6):734–7.

    PubMed  Google Scholar 

  87. Nelson Filho P, Silva LA, Leonardo MR, Utrilla LS, Figueiredo F. Connective tissue responses to calcium hydroxide-based root canal medicaments. Int Endod J. 1999;32(4):303–11.

    PubMed  Google Scholar 

  88. Shimizu T, Kawakami T, Ochiai T, Kurihara S, Hasegawa H. Histopathological evaluation of subcutaneous tissue reaction in mice to a calcium hydroxide paste developed for root canal fillings. J Int Med Res. 2004;32(4):416–21.

    PubMed  Google Scholar 

  89. Sharma S, Hackett R, Webb R, Macpherson D, Wilson A. Severe tissue necrosis following intra-arterial injection of endodontic calcium hydroxide: a case series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):666–9.

    PubMed  Google Scholar 

  90. Shahravan A, Jalali S, Mozaffari B, Pourdamghan N. Iran. Endod J. 2012;7(2):102–8.

    Google Scholar 

  91. Bramante CM, Luna-Cruz SM, Sipert CR, Bernadineli N, Garcia RB, Moraes IG, Vasconcelos BC. Alveolar mucosa necrosis induced by utilisation of calcium hydroxide as root canal dressing. Int Dent J. 2008;58(2):81–5.

    PubMed  Google Scholar 

  92. Sharma DS, Chauhan SP, Kulkarni VK, Bhusari C, Verma R. Accidental periapical extrusion of non-setting calcium hydroxide: unusual bone response and management. J Indian Soc Pedod Prev Dent. 2014;32(1):63–7.

    PubMed  Google Scholar 

  93. Sigurdsson A, Stancill R, Madison S. Intracanal placement of Ca (OH)2: a comparison of techniques. J Endod. 1992;18(8):367–70.

    PubMed  Google Scholar 

  94. Ribeiro DA. Do endodontic compounds induce genetic damage? A comprehensive review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):251–6.

    PubMed  Google Scholar 

  95. Abbasipour F, Akheshteh V, Rastqar A, Khalilkhani H, Asgari S, Janahmadi M. Comparing the effects of mineral trioxide aggregate and calcium enriched mixture on neuronal cells using an electrophysiological approach. Iran Endod J. 2012;7(2):79–87.

    PubMed  PubMed Central  Google Scholar 

  96. Barbosa SV, Burkard DH, Spangberg LS. Cytotoxic effects of gutta-percha solvents. J Endod. 1994;20(1):6–8.

    PubMed  Google Scholar 

  97. Vajrabhaya LO, Suwannawong SK, Kamolroongwarakul R, Pewklieng L. Cytotoxicity evaluation of gutta-percha solvents: Chloroform and GP-Solvent (limonene). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(6):756–9.

    PubMed  Google Scholar 

  98. Edgar SW, Marshall JG, Baumgartner JC. The antimicrobial effect of chloroform on enterococcus faecalis after gutta-percha removal. J Endod. 2006;32(12):1185–7.

    PubMed  Google Scholar 

  99. Ribeiro DA, Matsumoto MA, Marques ME, Salvadori DM. Biocompatibility of gutta-percha solvents using in vitro mammalian test-system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(5):e106–9.

    PubMed  Google Scholar 

  100. Asgary S, Ahmadyar M. One-visit RCT of maxillary incisors with extensive inflammatory root resorption and periradicular lesions: a case report. Iran Endod J. 2011;6(2):95–8.

    PubMed  PubMed Central  Google Scholar 

  101. Ribeiro DA, Marques ME, Salvador DM. In vitro cytotoxic and non-genotoxic effects of gutta-percha solvents on mouse lymphoma cells by single cell gel (comet) assay. Braz Dent J. 2006;17(3):228–32.

    PubMed  Google Scholar 

  102. Huang X, Ling J, Wei X, Gu L. Quantitative evaluation of debris extruded apically by using ProTaper universal Tulsa rotary system in endodontic retreatment. J Endod. 2007;33(9):1102–5.

    PubMed  Google Scholar 

  103. Metzger Z, Ben-Amar A. Removal of overextended gutta-percha root canal fillings in endodontic failure cases. J Endod. 1995;21(5):287–8.

    PubMed  Google Scholar 

  104. Martos J, Bassotto AP, Gonzalez-Rodriguez MP, Ferrer-Luque CM. Dissolving efficacy of eucalyptus and orange oil, xylol and chloroform solvents on different root canal sealers. Int Endod J. 2011;44(11):1024–8.

    PubMed  Google Scholar 

  105. Mushtaq M, Masoodi A, Farooq R, Yaqoob KF. The dissolving ability of different organic solvents on three different root canal sealers: in vitro study. Iran Endod J. 2012;7(4):198–202.

    PubMed  PubMed Central  Google Scholar 

  106. Bishop K, Dummer PMH. A comparison of stainless steel Flexofiles and nickel-titanium NiTiFlex files during the shaping of simulated canals. Int Endod J. 1997;30(1):25–34.

    PubMed  Google Scholar 

  107. Esposito PT, Cunningham CJ. A comparison of canal preparation with nickel-titanium and stainless steel instruments. J Endod. 1995;21(4):173–6.

    PubMed  Google Scholar 

  108. Gatot A, Arbelle J, Leiberman A, Yanai-Inbar I. Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex. J Endod. 1991;17:573–4.

    PubMed  Google Scholar 

  109. Kandian S, Chander S, Bishop K. Management of sodium hypochlorite extrusion beyond the root apex during root canal treatment: a case report. Prim Dent J. 2013;3:72–5.

    Google Scholar 

  110. Ercan E, Ozekinci T, Atakul F, Gul K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod. 2004;30:84–7. PubMed: 14977302

    PubMed  Google Scholar 

  111. John V. Cambruzzi, Raymond S. Greenfeld, (1983) Necrosis of crestal bone related to the use of excessive formocresol medication during endodontic treatment. Journal of Endodontics 9 (12):565–567.

    Google Scholar 

  112. Ozmeric N. Localized Alveolar Bone Necrosis Following Use Of An Arsenical Paste- a case report: Int Endod J. 2002;35:295–9.

    Google Scholar 

  113. Ranly DM. Pulpotomy therapy in primary teeth: New modalities for old rationales. Pediatr Dent 1994;16:403–9.

    Google Scholar 

  114. Restorative techniques in paediatric dentistry,. In: Duggal MS, editor. 2 nd ed.; 2002. p. 50–63.

    Google Scholar 

  115. Kim S, Liu M, Simchon S, Dorscher-Kim JE. Effects of selected inflammatory mediators in blood flow and vascular permeability in the dental pulp. Proc Finn Dent Soc 1992;88 Suppl 1:387–92.

    Google Scholar 

  116. The National Institute for Occupational Safety and Health (NIOSH) Formaldehyde. Available from: http://www.tricornet.com/nioshdbs/idlh/50000.htm [Last accessed 2006 on Mar 13].

  117. Daniel Araki Ribeiro, (2008) Do endodontic compounds induce genetic damage? A comprehensive review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 105 (2):251–256.

    Google Scholar 

  118. Speit G, Merk O. Evaluation of mutagenic effects of formaldehyde in vitro: detection of crosslinks and mutations in mouse lymphoma cells. Mutagenesis2002; 17: 183–187.

    Google Scholar 

  119. Luoping Zhang, Craig Steinmaus, David A. Eastmond, Xianjun K. Xin, Martyn T. Smith, (2009) Formaldehyde exposure and leukemia: A new meta-analysis and potential mechanisms. Mutation Research/Reviews in Mutation Research 681 (2-3):150–168.

    Google Scholar 

  120. David Joseph Wesley, F.James Marshall, Samuel Rosen, (1970) The quantitation of formocresol as a root canal medicament. Oral Surgery, Oral Medicine, Oral Pathology 29 (4):603–612.

    Google Scholar 

  121. Basak S K, Choudhuri Ayon, Basak S, Bakshi P K. Occular injury with Formocresol mistaken for eye drops. Bengal ophthalmic journal 2010; 10:37–39.

    Google Scholar 

  122. C. Gilvetti, S. R. Porter, S. Fedele, (2010) Traumatic chemical oral ulceration: a case report and review of the literature. BDJ 208 (7):297–300.

    Google Scholar 

  123. Physical and chemical injuries. In: Neville B W, Damm D, Allen C M, Bouquot J. Oral and maxillofacial pathology. 3rd ed. Philadelphia: W B Saunders; 2009:285–329.

    Google Scholar 

  124. M. Hulsmann, W. Hahn, (2000) Complications during root canal irrigation - literature review and case reports. International Endodontic Journal 33 (3):186–193

    Google Scholar 

  125. Cambreuzzi JV, Greenfield RS. Necrosis of crestal bone related to the use of excessive formooresol medication during endodontic treatment. J Endodon 1983:9:565–7.

    Google Scholar 

  126. Carol Anne Murdoch-Kinch, Mark E. Mallatt, Dale A. Miles, (1995) Oral mucosal injury caused by denture cleanser tablets. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 80 (6):756–758.

    Google Scholar 

Download references

Acknowledgements

We would like to extend our thankfulness to the postgraduate students in Hamdan Bin Mohammed College of Dental Medicine, Dubai, UAE, for their hard work in helping to put this chapter together, wishing them all the best in their future endodontic profession.

Dr. Reem Mahmoud

Dr. Dana Alraeesi

Dr. Nausheen Aga

Dr. Hessa Fezai

Dr. Maamoun Ataya

Author information

Authors and Affiliations

  1. MBR University of Medicine and Health Sciences, Dubai, UAE

    Zuhair Alkhatib B.D.S., M.S. & Rashid El Abed

Authors
  1. Zuhair Alkhatib B.D.S., M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rashid El Abed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zuhair Alkhatib B.D.S., M.S. .

Editor information

Editors and Affiliations

  1. Department of Endodontics, Apex Medical Clinics, Dubai, United Arab Emirates

    Priyanka Jain

Appendix 7.1

Appendix 7.1

Mild

Moderate

Severe

Mix by GDP/endodontist

Refer to OMFS/hospital

Refer to OMFS/ hospital

• Pain 0–3

• Pain 4–6

• Pain 7+

• Swelling <30%

• Swelling 30–5%

• Swelling >50%

• Bruising localized

• Bruising diffuse

• Bruising diffuse oral

• No ulceration/necrosis

• Intra-oral ulceration

• Ulcerations/necrosis

  

• Airway obstruction

  

• Neurovascular deficit

Immediate Mx

Immediate Mx

Immediate Mx

• Irrigation with saline/sterile water

• Analgesia (OTC)

Nonsteroidal anti-inflammatory

• Cold compress

• Investigations to identify perforation or root pathology

• Radiographs

 – IO LCPA

 – EO DPT

• Treatment as for mild injury

• Analgesia (opioids)

• Ref to OMFS

• Investigations to identify perforation or root pathology

• Radiographs

 – IO LCPA

 – EO DPT

• CBCT

• Treatment as for moderate injury

• IV antibiotics

• IV steroids

• Investigations

 – MRI

 – CT

Early Mx

Early Mx

Early Mx

• Warm towel compress

• Treatment as for mild injury

• Treatment as for moderate injury

• Regular review

• Antibiotics if there is any evidence of infection

• Incision and drainage of any collection

• Extraction of tooth (if required)

• Debridement of necrotic tissue

• Definitive airway (tracheostomy) if airway is compromised (emergency case)

Late Mx

Late Mx

Late Mx

• Complete RCT with a different irrigant

• Complete RCT with a different irrigant

• Lipodystrophy

 – Fillers

 – Implants

 – Coleman fat transfer

• Reviewed by OMFS

• Lipodystrophy

 – Fillers

 – Implants

• Coleman fat transfer

• Medical management of neuropathic pain

• Damage to motor nerves requiring advice from speech and language therapy, physiotherapy due to lip incompetence and poor oral seal

• Surgery

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alkhatib, Z., El Abed, R. (2018). Complications Due to Medicaments. In: Jain, P. (eds) Common Complications in Endodontics. Springer, Cham. https://doi.org/10.1007/978-3-319-60997-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60997-3_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60996-6

  • Online ISBN: 978-3-319-60997-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation