Sodium hypochlorite accident in a pediatric patient.

A sodium hypochlorite accident is a rare event in adults, but even more so in children. The purposes of this paper were to: report the case of a one-year, 10-month-old toddler who was treated under general anesthesia for early childhood caries, incurred a sodium hypochlorite accident following attempted pulpectomy in his primary maxillary central incisors, but made a full recovery without any sequelae after a typical four to six weeks course of disease; review the pertinent literature; and give recommendations on how to minimize the potential occurrence of such incidents.

The sodium hypochlorite accident: experience of diplomates of the American Board of Endodontics.

To better understand the etiology associated with sodium hypochlorite accidents, we surveyed diplomates of the American Board of Endodontics. Of the 314 diplomates who responded, 132 reported experiencing a sodium hypochlorite accident. Questions were asked about the age and sex of the patient as well as the tooth being treated, preoperative signs, symptoms, diagnosis, and radiographic appearance.

Anatomy of sodium hypochlorite accidents.

Sodium hypochlorite (NaOCl) in various concentrations is the most widely used endodontic irrigant, but it can be an irritant to vital tissues. There are several reports about the complications of irrigation with NaOCl during root canal therapy. Most of the complications are the result of accidental extrusion of the solution from the apical foramen or accessory canals or perforations into the periapical area.

Clinical update on root canal disinfection.

Endodontic disease is mediated by bacteria. Treatment goals should be directed to reducing the critical concentration of microbial irritants to the lowest level possible. Thorough canal instrumentation, with either stainless steel hand files or Ni-Ti rotary files, removes the bulk of tissue and microbial contamination, but adjunctive chemical agents are needed to optimize debridement.

Comparison of clinical outcomes using a nickel titanium rotary or stainless steel hand file instrumentation technique.

The purpose of this study was to evaluate the concept that novice clinicians could perform clinical endodontics better and more efficiently if the stainless steel hand file technique is replaced with a nickel titanium rotary file technique. In phase 1 of the study, every endodontic case performed by 2 groups was evaluated for total treatment time. In phase 2, the mesial roots of mandibular molars were evaluated for radiographic quality of completed obturation.