title: Sodium Hypochlorite Accident: A Systematic Review.
abstract: BACKGROUND
  Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series.
  
  
  METHODS
  A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search.
  
  
  RESULTS
  Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing.
  
  
  CONCLUSIONS
  A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.
authors.affiliation: UFR Odontologie de Marseille, Aix-Marseille Université, Assistance Publique des Hôpitaux de Marseille, Marseille, France; UMR 7268-ADÉS Aix-Marseille Université-EFS-CNRS, Faculté de Médecine de Marseille, France. Electronic address: maud.guivarch@gmail.com.
authors.forename: Maud
authors.initials: M
authors.lastname: Guivarc'h
authors.affiliation: UFR Odontologie de Marseille, Aix-Marseille Université, Assistance Publique des Hôpitaux de Marseille, Marseille, France; Centre Massilien de la Face, Marseille, France.
authors.forename: Ugo
authors.initials: U
authors.lastname: Ordioni
authors.affiliation: School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Hany Mohamed Aly
authors.initials: HM
authors.lastname: Ahmed
authors.affiliation: Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, California.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cohen
authors.affiliation: UFR Odontologie de Marseille, Aix-Marseille Université, Assistance Publique des Hôpitaux de Marseille, Marseille, France; UMR 7268-ADÉS Aix-Marseille Université-EFS-CNRS, Faculté de Médecine de Marseille, France.
authors.forename: Jean-Hugues
authors.initials: JH
authors.lastname: Catherine
authors.affiliation: UFR Odontologie de Marseille, Aix-Marseille Université, Assistance Publique des Hôpitaux de Marseille, Marseille, France; Giboc, ISM UMR 7287 CNRS, Aix Marseille Université, Marseille, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bukiet
mesh_terms: D006801:Humans; D012388:Root Canal Irrigants / Q000009:adverse effects*; D018915:Root Canal Preparation / Q000009:adverse effects*; D012973:Sodium Hypochlorite / Q000009:adverse effects*
chemical_list: D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite
keywords: Apical extrusion; endodontics; irrigant; review; sodium hypochlorite