Sodium Hypochloride Extrusion Flashcards
1
Q
Common symptoms of NaOCl extrusion
A
- pain
- swelling
- bruising
- ecchymosis
- hemorrhage
- neurological complications
- airway obstruction
2
Q
Classic accident
A
- ecchymosis
- manifests along the course of superficial venous vasculature
3
Q
Risk Factors
A
- excessive pressure during irrigation
- needle locked within canal
- loss of control of WL
- larger apical dismeters/ constriction; ie: RR, immature teeth, developmental anomalies
- close proximity to sinus
- high NaOCl concentration
4
Q
Flow rate of NaOCl
A
1ml/ 15s
- do not exceed this
5
Q
Management of NaOCl extrusion
A
- all tx must stop
- keep calm and not to alarm pt
- advise pt of what has happened and reassure them the immediate management
- where pain is, consider administration of LA via a block
- if profused bleeding occurs, allow this to cotinue until haemostasis observed
- steroid containing intracanal medicament should be placed in RC, ensuring no pressure is used during application
- do not obturate tooth at this time, but seal to coronal access cavity
- cold compression
- warm compression for resolution of soft tissue swelling and elimination of haematoma
- Analgesics
(Ibuprofen 400-600mg/ Paracetamol 1000mg) - review within 24 hrs
- refer if severe
6
Q
Guidelines for use of NaOCl
A
- pre-op radiographs for if open apices, WL
- pre-endodontic build up if needed
- disposable bib and eyewear
- dental dam with orasealTM
- ensure floss is to secure clamp during placement and removed after dam is seated
- test dental damn with chlorhexidine
- syringes are labelled
- side- vented needle for irrigation
- fill syringe less, 3/4 full to aid control
- use silicone stop on syringe and set to 2mm short WL
- pass endo syringe behind pt’s head
- irrigating needle should not bind in RC at any time
- depress with index finger not thumb to reduce pressure
- report any irrigation incident to senior staff
- raise concerns to senior member of NHS/ University staff if necessary
