Sodium Hypochlorite Extrusion

Question 1

name six common symptoms of sodium hypochlorite extrusion into periradicular tissues

Answer 1

pain
swelling
ecchymosis
haemorrhage
neurological complications
airway obstruction

Question 2

what are risk factors of hypochlorite extrusion

Answer 2

excessive pressure during irrigation
needle locked within canal
loss of control of working length
large apical diameters (root resorption/ immature teeth/ developmental abnormality)
anatomical factors
higher sodium hypochlorite concentration

Question 3

what is the max flow rate for sodium hypochlorite

Answer 3

1ml/ 15 seconds

Question 4

what are the steps of management for sodium hypochloride extrusion

Answer 4

all treatment must stop
keep calm
advise patent of what has happened
if pain present - administer LA
if profuse bleeding through root canal allow to continue until haemostasis achieved
steroid containing medicament placed in root canal
do not obturate the tooth - seal access cavity

Question 5

what instructions should you give the patient for home care after sodium hypochlorite extrusion

Answer 5

cold compress first few days
warm compress for resolution of swelling
analgesics
review patient in 24 hours
prescription for abx - patient specific
refer if severe

Question 6

what are the guidelines for use of sodium hypochlorite

Answer 6

careful preoperative radiographic assessment
patient is provided with bib
everyone is wearing protective eyewear
dental dam used to isolate tooth
test dental dam by irrigating with chlorhexidine first
syringes are clearly labelled with adhesive labels
use side vented needle for irrigation
only fill syringe 3/4
needle has silicone stop that is set to 2mm short of working length
syringe is passed behind patient’s head
depress plunger on syringe with index finger not thumb