{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:33:47Z","timestamp":1777494827640,"version":"3.51.4"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ), Brazilian Governmental Institution"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Dent"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u2019s 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.<\/jats:p>","DOI":"10.1055\/s-0040-1714173","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T23:14:48Z","timestamp":1597965288000},"page":"511-516","source":"Crossref","is-referenced-by-count":4,"title":["Mucosal Fenestration After 2% Chlorhexidine Extrusion Used in Substitution of Sodium Hypochlorite: A Case Report"],"prefix":"10.1055","volume":"14","author":[{"given":"Fl\u00e1vio Rodrigues Ferreira","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Igua\u00e7u University, Nova Igua\u00e7u, Rio de Janeiro, Brazil"},{"name":"Post Graduation Program, Grande Rio University (UNIGRANRIO), Duque de Caxias, Rio de Janeiro, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00edlia F.","family":"Marceliano-Alves","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Igua\u00e7u University, Nova Igua\u00e7u, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline Carvalho de","family":"Souza","sequence":"additional","affiliation":[{"name":"Brazilian Association of Dentistry, Niter\u00f3i, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Fagundes","family":"Campello","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Igua\u00e7u University, Nova Igua\u00e7u, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1600-9657.1998.tb00824.x","article-title":"Effectiveness of four chemical solutions in eliminating Bacillus subtilis spores on gutta-percha cones","volume":"14","author":"J F Siqueira Jr","year":"1998","journal-title":"Endod Dent Traumatol"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/j.joen.2016.06.006","article-title":"Antibacterial effectiveness of 2 root canal irrigants in root-filled teeth with infection: a randomized clinical trial","volume":"42","author":"H Zandi","year":"2016","journal-title":"J Endod"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.joen.2005.09.014","article-title":"Root canal irrigants","volume":"32","author":"M Zehnder","year":"2006","journal-title":"J Endod"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0099-2399(85)80197-7","article-title":"Cytotoxic effects of NaOCl on vital tissue","volume":"11","author":"E L Pashley","year":"1985","journal-title":"J Endod"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.joen.2013.01.001","article-title":"Periapical pressures developed by nonbinding irrigation needles at various irrigation delivery rates","volume":"39","author":"S Khan","year":"2013","journal-title":"J Endod"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.joen.2008.07.021","article-title":"The sodium hypochlorite accident: experience of diplomates of the American Board of Endodontics","volume":"34","author":"D J Kleier","year":"2008","journal-title":"J Endod"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1038\/bdj.2007.374","article-title":"Review: the use of sodium hypochlorite in endodontics\u2013potential complications and their management","volume":"202","author":"H R Spencer","year":"2007","journal-title":"Br Dent J"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.joen.2016.09.023","article-title":"Sodium hypochlorite accident: a systematic review","volume":"43","author":"M Guivarc\u2019h","year":"2017","journal-title":"J Endod"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.tripleo.2007.01.027","article-title":"Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis","volume":"104","author":"J F Siqueira Jr","year":"2007","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.joen.2016.03.019","article-title":"disinfecting effects of rotary instrumentation with either 2.5% sodium hypochlorite or 2%\u00a0chlorhexidine as the main irrigant: a\u00a0randomized clinical study","volume":"42","author":"I N R\u00f4\u00e7as","year":"2016","journal-title":"J Endod"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S1079-2104(03)00360-3","article-title":"Zaia AA, Ferraz CC, de Souza-Filho FJ. 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