Complicaciones por extravasación de hipoclorito de sodio en endodoncia. Revisión bibliográfica

Abstract

This study aims to identify the complications resulting from the extrusion of sodium hypochlorite during endodontic procedures through a comprehensive literature review. A systematic search and data collection were conducted using scientific databases such as PubMed, Scopus, and Web of Science, focusing on clinical studies, systematic reviews, and relevant case reports published between 2018 and 2024. The findings indicate that sodium hypochlorite extrusion may lead to a range of severe complications, including soft tissue inflammation, hemorrhage, osteonecrosis, and even irreversible neurological damage. These adverse outcomes are often associated with factors such as excessive irrigation pressure, inappropriate needle selection, and complex root canal anatomy, which collectively increase the risk of such incidents. Among the most effective preventive strategies are the use of side-vented, blunt-end irrigation needles, control of irrigation pressure, and thorough preoperative anatomical assessment. For clinical management, the main therapeutic measures include the use of saline solution for irrigation, anti-inflammatory and antibiotic therapy, and, in more severe cases, surgical treatment. Both the technique employed during treatment and the use of sodium hypochlorite as an irrigant can compromise patient health if not handled with proper caution. Thus, developing and standardizing prevention and management protocols represent the first steps toward achieving a more favorable prognosis. Keywords: sodium hypochlorite, endodontics, extrusion, complications, clinical management