Complications of sodium hypochlorite extravasation into periapical tissues during endodontic treatment [Complicaciones por extravasación de hipoclorito de sodio en tejidos periapicales durante el tratamiento endodóntico]
DOI:
https://doi.org/10.62574/nzwc3110Keywords:
sodium hypochlorite, root canal irrigants, endodonticsAbstract
Objective: To analyse the use of sodium hypochlorite in endodontics, its associated risks, and strategies to prevent complications from extravasation. Method: Systematic review following PRISMA guidelines. Twenty articles published between 2020 and 2025 were analysed. Results: Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant due to its antimicrobial properties and ability to dissolve necrotic tissue. However, its extravasation into periapical tissues can cause severe complications: inflammation, tissue necrosis, facial haematomas, paraesthesia, and airway compromise. Higher concentrations increase antimicrobial efficacy but also increase cytotoxicity. 2.5% NaOCl showed lower toxicity than higher concentrations. Preoperative evaluation with cone beam computed tomography allows the identification of anatomical defects that increase the risk of extrusion. Techniques such as negative pressure irrigation, ultrasonic activation, use of 30G needles, and control of application time (minimum 30 seconds for 5mL) significantly reduce the risk of accidents.
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