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CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(03): 511-516
DOI: 10.1055/s-0040-1714173
Case Report

Mucosal Fenestration After 2% Chlorhexidine Extrusion Used in Substitution of Sodium Hypochlorite: A Case Report

Flávio Rodrigues Ferreira Alves
1   Department of Endodontics, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
2   Post Graduation Program, Grande Rio University (UNIGRANRIO), Duque de Caxias, Rio de Janeiro, Brasil
,
Marília F. Marceliano-Alves
1   Department of Endodontics, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
,
Aline Carvalho de Souza
3   Brazilian Association of Dentistry, Niterói, Brazil
,
Andrea Fagundes Campello
1   Department of Endodontics, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
› Author Affiliations Funding This study was supported by grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Brazilian Governmental Institution.
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Abstract

This report describes a case of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) extrusion through the apical foramen, causing acute pain, swelling and mucosal fenestration. A 62-year-old woman was referred for endodontic treatment in the first left maxillary premolar with a diagnosis of necrotic pulp. After the root canal irrigation with 2.5% NaOCl, the patient felt a burning sensation and pain. Discrete swelling and redness were noted in the patient’s face at the end of the session. Antibiotic and corticosteroids were prescribed. In the next appointment, 2% CHX was used, but another episode of extrusion occurred, with a sudden acute pain and intense swelling within a few minutes after the injection. After 2 weeks, the patient exhibited a left-side facial swelling extending anterior and inferior to the left zygomatic arch and superior to the body of the mandible. Oral antibiotic and anti-inflammatory drugs were administered. After 10 days, the swelling had completely diminished, but a mucosal fenestration and tooth mobility were verified. A cone beam CT was requested and showed a periapical lesion involving both buccal and palatal roots. After a prosthetic evaluation, the tooth extraction was indicated. One week after tooth removal, the mucosa was completely healed.

Keywords

chlorhexidine - facial edema - root canal irrigation - root canal treatment - sodium hypochlorite.


Publication History

Article published online:
20 August 2020

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