title: Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant.
abstract: OBJECTIVE
  To present a clinical case that illustrates the toxicity of concentrated sodium hypochlorite (NaOCl) on vital tissues.
  
  
  CONCLUSIONS
  The severe clinical consequences of extruding concentrated NaOCl into the periradicular tissues during root canal irrigation are described. After diagnosis of external resorption in tooth 34, endodontic treatment was initiated. Following irrigation with a concentrated NaOCl solution, a rapidly developing swelling and haematoma were visible. During the next few days, an extensive bruise and local necrosis of the oral mucosa developed. After healing of the involved tissues, the canal was prepared and obturated. At this time, no clinical symptoms remained.
  
  
  CONCLUSIONS
  * The use of concentrated NaOCl as a root canal irrigant might cause severe clinical problems when extruded into vital tissues. * The present report confirms the known toxicity of NaOCl to soft tissues following inadvertent extrusion. * To avoid extrusion, it is always prudent to confirm the length and integrity of the root canal system before irrigating with concentrated solutions.
authors.affiliation: Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Martin-Luther-University, Halle, Germany. christian.gernhardt@medizin.uni-halle.de
authors.forename: C R
authors.initials: CR
authors.lastname: Gernhardt
authors.forename: K
authors.initials: K
authors.lastname: Eppendorf
authors.forename: A
authors.initials: A
authors.lastname: Kozlowski
authors.forename: M
authors.initials: M
authors.lastname: Brandt
mesh_terms: D003786:Dental Pulp Cavity / Q000033:anatomy & histology; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000139:chemically induced; D006801:Humans; D008046:Lip / Q000187:drug effects* / Q000293:injuries / Q000473:pathology; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000293:injuries / Q000473:pathology; D009336:Necrosis; D009811:Odontometry; D012388:Root Canal Irrigants / Q000008:administration & dosage / Q000009:adverse effects*; D012391:Root Resorption / Q000150:complications; D012973:Sodium Hypochlorite / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite