title: Use of a 660-nm Laser to Aid in the Healing of Necrotic Alveolar Mucosa Caused by Extruded Sodium Hypochlorite: A Case Report.
abstract: The extrusion of sodium hypochlorite through the apical foramen is an accident that can occur during the flushing procedure in endodontic treatment. The symptomatology is immediate and intense, and there is a long period before the tissues return to normal. Low-level laser therapy might be useful as an adjunctive treatment for damaged soft tissues because of its anti-inflammatory and analgesic effects, which may reduce edema and prevent infection. In this clinical case, the accidental leakage of 1% sodium hypochlorite during the preparation of the root canal of a maxillary right central incisor is reported. This leakage caused immediate and intense pain and edema formation and resulted in an extensive necrotic area in the alveolar mucosa adjacent to the root of the treated tooth. The conventional treatment protocol was combined with low-level laser therapy. Clinical and radiographic examinations after 7 months revealed complete repair of the necrotic area with no paresthesia and further indicated the integrity of the apical region of the tooth where the extrusion of sodium hypochlorite occurred. The combination of low-level laser therapy with a conventional treatment protocol in this case of the extrusion of 1% sodium hypochlorite resulted in the healing of the wounds.
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Clovis Monteiro
authors.initials: CM
authors.lastname: Bramante
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil. Electronic address: jussaroduque@hotmail.com.
authors.forename: Jussaro Alves
authors.initials: JA
authors.lastname: Duque
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Bruno Cavalini
authors.initials: BC
authors.lastname: Cavenago
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Rodrigo Ricci
authors.initials: RR
authors.lastname: Vivan
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Alexandre Silva
authors.initials: AS
authors.lastname: Bramante
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Flaviana Bombarda
authors.initials: FB
authors.lastname: de Andrade
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Marco Antonio Hungaro
authors.initials: MA
authors.lastname: Duarte
mesh_terms: D004202:Disinfectants / Q000008:administration & dosage / Q000633:toxicity*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000473:pathology; D009336:Necrosis / Q000139:chemically induced* / Q000628:therapy*; D011861:Radiography, Dental; D018915:Root Canal Preparation / Q000009:adverse effects; D012973:Sodium Hypochlorite / Q000008:administration & dosage / Q000633:toxicity*; D016896:Treatment Outcome
chemical_list: D004202:Disinfectants; D012973:Sodium Hypochlorite
keywords: Apical extrusion; irrigation; low-level laser therapy; sodium hypochlorite