{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:06:56Z","timestamp":1791216416731,"version":"4.1.0"},"reference-count":84,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Fundamemntal Clinical Pharma"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Sodium hypochlorite (NaOCl) is considered as the reference irrigation solution in endodontics. However, NaOCl\u2010related accidents may occur, and non\u2010dentist health professionals might under\u2010recognize this rare adverse effect although it is potentially severe, with possible medical and aesthetic sequelae. We performed a literature review to provide to non\u2010dentist healthcare professionals a large picture of symptoms, management and potential consequences of NaOCl accidents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We queried PubMed and the French Pharmacovigilance database and retrieved 76 cases for analysis (70 from 57 published articles, and six from the database).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis showed that patients were mostly women (79%), aged around of 42\u2009years, undergoing upper jawbone (74%) endodontic procedure. NaOCl concentration ranged from 1% to 10%, with 0.5 to 30\u2009mL injected. Most cases (86%) corresponded to an accidental extrusion beyond the root apex to the periapical tissues, followed by tissular injection by error (8%) and extrusion into the maxillary sinus (3%). Local symptoms always occurred within 24\u2009h, mostly pain (99%), edema (89%) and\/or ecchymosis (61%). Complications were mainly neurological (29%), necrotic (22%) and cutaneous (9%). Most of patients (76%) fully recovered after medical management but 18 (24%) required surgical management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Any healthcare professional should be aware of the classical symptomatic triad of NaOCl accident with sudden pain, haemorrhage\/ecchymosis and swelling, to start or recommend adequate management. Patients should be reassured, but a close follow\u2010up is necessary to avoid delayed complication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/fcp.12985","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T04:34:30Z","timestamp":1706157270000},"page":"630-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Sodium hypochlorite accident diagnosis and management: Analysis from the literature and the French pharmacovigilance database"],"prefix":"10.1111","volume":"38","author":[{"given":"Zahoua","family":"Kartit","sequence":"first","affiliation":[{"name":"Centre R\u00e9gional de Pharmacovigilance CHRU Nancy\u2010Brabois  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Delacroix","sequence":"additional","affiliation":[{"name":"Service de Dermatologie\u2010allergologie CHRU Nancy\u2010Brabois  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Clement","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Pr\u00e9vention\u2010\u00c9pid\u00e9miologie\u2010\u00c9conomie de la Sant\u00e9\u2010Odontologie L\u00e9gale CHRU Nancy, Facult\u00e9 d'odontologie  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Beurrier","sequence":"additional","affiliation":[{"name":"Centre R\u00e9gional de Pharmacovigilance CHRU Nancy\u2010Brabois  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudie","family":"Mouton\u2010Faivre","sequence":"additional","affiliation":[{"name":"Service de Dermatologie\u2010allergologie CHRU Nancy\u2010Brabois  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0225-3178","authenticated-orcid":false,"given":"Nadine","family":"Petitpain","sequence":"additional","affiliation":[{"name":"Centre R\u00e9gional de Pharmacovigilance CHRU Nancy\u2010Brabois  Vandoeuvre\u2010l\u00e8s\u2010Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.05.023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2007.02.012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2016.09.023"},{"issue":"1","key":"e_1_2_11_5_1","first-page":"17","article-title":"Sodium hypochlorite accidents in dentistry. A systematic review of published case reports","volume":"22","author":"Shetty SR","year":"2020","journal-title":"Stomatologija"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3290\/j.qi.b1492001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcd.jcd_422_22"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102591.2000.00303.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050168420963308"},{"key":"e_1_2_11_10_1","first-page":"544","article-title":"Anatomy of sodium hypochlorite accidents","volume":"28","author":"Mehdipour O","year":"2007","journal-title":"Compend Contin Educ Dent"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2013.08.012"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e23060"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/jispcd.JISPCD_206_18"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v89i1.6067"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2009.166"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030\u20104220(74)90097\u20108"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.9734\/BJMMR\/2016\/29062"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0143\u20102885.2004.00804.x"},{"issue":"3","key":"e_1_2_11_19_1","first-page":"1067","article-title":"Inadvertent extrusion of sodium hypochlorite during endodontic treatment: case report","volume":"4","author":"Campos P","year":"2016","journal-title":"JSM Den"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099\u20102399(89)80031\u20107"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010057\u20100095"},{"key":"e_1_2_11_22_1","first-page":"532","article-title":"Single visit endodontic management of sodium hypochlorite accident: a case report","author":"AL\u2010Zahrani DMS","year":"2016","journal-title":"Res Desk"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/app12178525"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2008.12.024"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCIDE.S79436"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u20102014\u2010207480"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010005\u20101304"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229\u20105194.142952"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.5272\/jimab.2016223.1269"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102591.2011.02009.x"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/2231\u20100762.192939"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2021.09.014"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.21726\/rsbo.v11i2.844"},{"key":"e_1_2_11_34_1","first-page":"61","article-title":"Sodium hypochlorite accidentally extruded beyond the apical foramen","volume":"30","author":"Wang S\u2010H","year":"2010","journal-title":"J Med Sci"},{"key":"e_1_2_11_35_1","first-page":"11","article-title":"Accidental extrusion of sodium hypochlorite during endodontic treatment: a case report","volume":"11","author":"Amador C","year":"2016","journal-title":"J Surg Clin Dent"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1308\/205016814812135805"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.5604\/00114553.1035091"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.5933\/JKAPD.2015.42.3.264"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.12968\/denu.2009.36.1.14"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2015.07.011"},{"key":"e_1_2_11_41_1","first-page":"36","article-title":"Accidental injection of sodium hypochlorite beyond the root apex","volume":"14","author":"Balto H","year":"2002","journal-title":"Saudi Dent J"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20109657.1989.tb00361.x"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2010.07.041"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102591.2005.01017.x"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.12968\/denu.2009.36.1.7"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1179\/2046905512Y.0000000042"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.46889\/JDHOR.2022.3103"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2005.06.021"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/102490791001700212"},{"key":"e_1_2_11_50_1","first-page":"08","article-title":"Accidental extrusion of sodium hypochlorite beyond root apex\u2013a case report","volume":"05","author":"Reddy RRK","year":"2018","journal-title":"Case Rep Odontol"},{"key":"e_1_2_11_51_1","first-page":"21","article-title":"Accidental extrusion of sodium hypochlorite during endodontic treatment: a case report","volume":"5","author":"Bither R","year":"2013","journal-title":"Global J Dent Oral Hygiene"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.11138\/ads\/2017.8.3.117"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.4317\/jced.59862"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/247547"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e318226e166"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030\u20104220(91)90313\u20102"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099\u20102399(06)81725\u20105"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.4317\/jced.50767"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104484"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u20102019\u2010233206"},{"key":"e_1_2_11_61_1","first-page":"35","article-title":"Inadverdent injection of sodium hypochlorite into periapical tissues: two case reports","volume":"30","author":"Ke\u00e7eci AD","year":"2006","journal-title":"Clin Dent Res"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.2014.19"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2000.0021"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1834\u20107819.1993.tb05497.x"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2212\u20104268(11)60013\u20104"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102591.2007.01340.x"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099\u20102399(06)80684\u20109"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13974"},{"key":"e_1_2_11_69_1","unstructured":"American Association of Endodontists.Root Canal Irrigants and Disinfectants.2011. [accessed on 4 December 2023]. URLhttps:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2017\/07\/rootcanalirrigantsdisinfectants.pdf"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1834\u20107819.1998.tb00173.x"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102591.2004.00749.x"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2008.07.021"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2014.1099"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091\u20106749(96)80067\u20104"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.07.046"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.12781"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1067\/moe.2001.116812"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2007.04.001"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2012.01.006"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2017.08.008"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102591.2003.00670.x"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2016.12.006"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2023.05.003"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2016.08.017"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2018.1543889"}],"container-title":["Fundamental &amp; Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/fcp.12985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T09:25:45Z","timestamp":1721208345000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/fcp.12985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,24]]},"references-count":84,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/fcp.12985"],"URL":"https:\/\/doi.org\/10.1111\/fcp.12985","archive":["Portico"],"relation":{},"ISSN":["0767-3981","1472-8206"],"issn-type":[{"value":"0767-3981","type":"print"},{"value":"1472-8206","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,24]]},"assertion":[{"value":"2023-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}