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Complications of Endodontic Irrigation: Dental, Medical, and Legal

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Endodontic Irrigation

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Abstract

The objective of endodontic treatment is to treat and/or prevent apical periodontitis. Historically, there have been many irrigating agents that have been used to achieve this objective. Sodium hypochlorite, to date, still remains the irrigant of choice to break down the organic tissue of the dental pulp, debride necrotic tissue from the root canal space, and confirm negative bacteria cultures. Sodium hypochlorite while being an excellent endodontic irrigant can also cause devastating complications if extruded past the apex into the periradicular tissues.

This chapter will outline the complications and sequelae that potentially can occur if sodium hypochlorite is accidentally extruded past the apex and into the periradicular tissues. The mechanism of action of the irrigation accident will be detailed as well as preventative measures that can be employed to avoid such occurrences in addition to suggested treatment recommendations should such an accident occur. In addition, the legal and ethical implications with respect to the use and delivery of sodium hypochlorite during endodontic treatment will also be discussed.

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Note and Acknowledgement

Figure 11: The pressures recorded for the macro cannula were not reported in the Khan study [59] but were mentioned in Goode [79] as unpublished results. Goode coauthored the Khan study [59].

Dr. John Schoeffel, inventor and royalty recipient (SybronEndo/Kerr Endodontics) of the EndoVac system, originally envisioned the concept of NaOCl traveling in the venous system after scrutinizing the Bradford study [68] and the associated references. I am grateful for his help in explaining the concept of intraosseous fluid delivery and the intracanal fluid dynamics that affect periapical pressure as well as his assistance in organizing the logic path and graphics for this chapter.

Dr. Ovidiu Cioanu (www.ovidiu.ca) produced graphics 4 B and C.

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Authors and Affiliations

  1. Associate in Dentistry, Graduate, Department of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada

    Gary Glassman DDS, FRCD(C)

  2. Adjunct Professor of Dentistry, University of Technology, Kingston, Jamaica

    Gary Glassman DDS, FRCD(C)

  3. Private Practice, Endodontic Specialists, Toronto, ON, Canada

    Gary Glassman DDS, FRCD(C)

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  1. Gary Glassman DDS, FRCD(C)
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Correspondence to Gary Glassman DDS, FRCD(C) .

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  1. Department of Dentistry, University of Toronto, Toronto, Canada

    Bettina Basrani

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Glassman, G. (2015). Complications of Endodontic Irrigation: Dental, Medical, and Legal. In: Basrani, B. (eds) Endodontic Irrigation. Springer, Cham. https://doi.org/10.1007/978-3-319-16456-4_6

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  • DOI: https://doi.org/10.1007/978-3-319-16456-4_6

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