Injection Of Sodium Hypochlorite Research Articles

Injection of sodium hypochlorite into soft tissues of the oral cavity: A literature review with clinical preventive recommendations

Injection of sodium hypochlorite (NaOCl) solution instead of local anaesthetic (LA) solution is an iatrogenic error with serious consequences including medico-legal implications. Such cases have been reported despite recommended precautionary measures. The purpose of this article is to review the literature on such cases and present clinical preventive recommendations. Electronic search was conducted in PubMed/Medline, Google Scholar, Cochrane, Scopus, Lilacs, ScienceDirect, and Crossref databases for articles reporting accidental or mistaken or inadvertent injection of NaOCl instead of LA during dental or endodontic treatment. Articles reporting NaOCl accident due to extrusion or injection of NaOCl beyond root confines were excluded. A total of 11 articles were found and reviewed. Data pertaining to the patient, injected NaOCl, cause, clinical manifestations, management, hospitalization, healing and recovery, and long-term or residual effects were extracted, compiled, and analysed for interpretation and discussion. Injection of NaOCl instead of LA into the soft tissues leads to varying clinical manifestations with unpredictable extent, outcome, and recovery period. The onus lies with the clinician to prevent it. Therefore, a clinician must take all the precautionary measures and confirm the identity of LA and NaOCl solutions before delivering them. The presented clinical recommendations assist clinicians to prevent it, including its potential medico-legal consequences. However, in case of such an unfortunate event, it is crucial to immediately identify and quickly manage it to limit the tissue damage or complications.

Accidental Injection of Sodium Hypochlorite into Buccal Mucosa Before Endodontic Treatment: Case Report

Accidental Injection of Sodium Hypochlorite into Buccal Mucosa Before Endodontic Treatment: Case Report

Sodium-ypochlorite injection in antecubital fossa: A case report and literature review.

IntroductionCaustic cutaneous injections are rare and may result in challenging soft tissue defects necessitating urgent surgical reconstruction to preserve vital structures.We report a unique case of self-inflicted sodium hypochlorite injection to the left antecubital fossa as a suicidal attempt, which resulted in an exposed median nerve and brachial artery. The adventitia of the brachial artery was injured in this case; hence, the risk of an arterial blowout was considerable.After thorough debridement, the defect was reconstructed successfully with a reverse lateral arm flap.ConclusionHousehold bleach (sodium hypochlorite) injections are rare and may result in challenging soft tissue defects necessitating urgent surgical reconstruction to preserve vital structures.

Optimization of the water treatment process in an Italian winery: A case study

Water is an essential ingredient in wine production. The winery plant considered in this study, located in the Langhe area (Piedmont, NW Italy), used approx.100,000 m3 per year of high quality water for cleaning and sanitation operations. Water was collected from the local shallow aquifer and contained high concentrations of dissolved iron (Fe(II), 800 – 3500 μg/L) and manganese (Mn(II), 300–700 μg/L). The water treatment plant (WTP) owned by the winery included a series of treatment processes (air sparging and sodium hypochlorite injection, settling, filtration on a quartzite – pyrolusite filter, removal of excess chlorine with an activated carbon filter and, finally, microfiltration and reverse osmosis, RO) that were deemed to be adequate to make the groundwater compliant with potable uses. However, a survey carried out by the authors revealed the presence of two critical issues in the WTP’s management, concerning the Fe(II) and Mn(II) oxidation and removal, and the backwashing of the dual media filter. Firstly, the results of pilot tests demonstrated that the process of air sparging was sufficient for the oxidation of iron and that NaClO was not necessary for that operation. The present concentration of pure oxidant, of 21.5 mg NaClO/L, could be reduced by at least 75 %, without altering the capacity of the WTP in the removal of the two metals. Secondly, a new combination of water fluxes could improve the efficiency of the dual media filter backwashing, thus allowing to simultaneously avoid the use of the RO corrosive concentrate and to minimize the use of high quality water.In the end, a very basic cost model was used to compare the unit cost for water treatment in the current scenario and after the introduction of the two proposed solutions. Specifically, that model considered three cost items: operating costs (that included four sub-items: mortgage, maintenance, consulting and cost for non-amortizable raw materials and consumable), the costs for the purchase of the chemicals necessary for the water treatment process, and the energy costs. The results coming from the application of the cost model demonstrated that the introduction of the proposed solutions into the WTP, at no additional costs, had an undeniable positive impact on the final unit cost of the treated water, that was reduced by 20 %.

Bir İntravenöz İntihar Olgusu: Sodyum Hipoklorit & Benzalkonyum Klorür

Sodium hypochlorite as a strong oxidant- bleaching agent and benzalkonium chloride as a biocide is frequently used agents for cleaning and sterilization purposes, both in health care units and at home. Despite the injection of sodium hypochlorite into the venous system has been described many times before, to our knowledge self-administration of a mixture of sodium hypochlorite and benzalkonium chloride has not been reported by a way of suicide. Our patient was a health Professional who was running a sport and beauty center. The amount of total concentration intake that patient said prepared by himself (400 ml of sodium hypochlorite, 400 ml of benzalkonium chloride, and 1000 ml of isotonic liquid ) was unknown but it was known that >150–200 mL of hypochlorite in adults is enough for systemic poisoning. The cross effects of chemicals on human tissues and organs are unpredictable, our patient was discharged by recovering all systemic damages except permanent kidney damage. This study aims to present a rare suicide poisoning event and adverse clinical sequelae.

Inadvertent Injection of Sodium Hypochlorite to Oral Mucosa

Inadvertent Injection of Sodium Hypochlorite to Oral Mucosa

TEMPO Mediated Oxidation Optimization on Thermomechanical Pulp for Paper Reinforcement and Nanomaterial Film Production

The 4-acetamido-TEMPO mediated oxidation system is well known on pure cellulose, but further investigation on more complex cellulose sources, such as thermomechanical pulp that is also composed of hemicelluloses and lignin, is needed. The reaction on wood pulp allows improvement in paper strength and nanofibril material production. However, the effects of the reaction parameters are not known enough to scale up the oxidation. With the help of two experimental designs, the chemical amounts, reaction temperature and time, sodium hypochlorite injection time, and nanofibril dispersion time were all studied. During the experiments, it was possible to observe pulp bleaching or delignification. Increasing the 4-acetamido-TEMPO amount promoted the pulp oxidation. In contrast, a large excess of sodium bromide and sodium hypochlorite was advantageous for pulp bleaching and delignification. High temperature favored the oxidation but delignification was induced by the oxidation. For the paper reinforcement, chemical amounts were optimized according to the end user needs. For nanomaterial production, both oxidation and delignification were needed. The reaction had to generate a significant delignification and increase pulp carboxyl content higher than 1600 mmol/kg to be able to produce nanofibril material. The results showed new leads on the various times required for future industrial implementation.

Comparative evaluation of the effect of two commonly used irrigants on bone: An ex-vivo study

Introduction: The cause and effect of sodium hypochlorite and chlorhexidine gluconate accidents on vital tissues like skin, subcutaneous tissues, nerves, periodontal tissues have been extensively addressed through case reports; however, the pathological changes in bone after the their inadvertent extrusion through apical foramen during routine root canal treatment have not been investigated. Learning more about physical and histologic changes in bone might lead to treatment protocol changes. The purpose of this study was to compare the histological effects of sodium hypochlorite and chlorhexidine gluconate on the alveolar bone. Aim: To compare the effect of 3% Sodium hypochlorite and 2% Chlorhexidine gluconate on goat bone. Objective: To assess the histopathological changes in the goat mandible exposed to 0.5ml of 3% Sodium hypochlorite and 2% Chlorhexidine gluconate for a period of 30 minutes. Methods: A freshly cut goat mandible was obtained and immediately cut into 4 mm blocks which were further sectioned into 2×2×2mm blocks. Adjacent surface were selected for the shallow injection of sodium hypochlorite and chlorhexidine gluconate and saline. Histopathological evaluation of the bone specimens were conducted under nine parameters. Results: Histologically, both sodium hypochlorite and chlorhexidine gluconate causes detrimental effects on bone. However, the results indicated that sodium hypochlorite, causes more degradation to the bone as compared to chlorhexidine gluconate. Calcified elements such as cortical bone remains unaffected.

Sodium hypochlorite-induced acute kidney injury

Sodium hypochlorite (bleach) is commonly used as an irrigant during dental procedures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI). In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

상악 유중절치 재근관 치료에서 차아염소산나트륨의 합병증에 대한 증례 보고

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia, cold compression and adequate medication should be done.

Inadvertent Injection of Sodium Hypochlorite into the Periradicular Tissues during Root Canal Treatment

This paper describes a sodium hypochlorite (NaOCl) incident occurring during routine endodontic treatment of a patient who presented with chronic periapical periodontitis of a maxillary canine tooth and discusses the immediate and late treatment of this case.

Sodium Hypochlorite Accident – A Complication of Poor Access Cavity Design

A case is presented of soft tissue damage resulting from inadvertent injection of sodium hypochlorite through a perforation created during root canal treatment of a mandibular incisor. The importance of access cavity design to help avoid such complications is highlighted and the anatomy of the mandibular incisor is discussed. Measures to minimize the risk of a hypochlorite accident and its potentially serious complications are proposed.

Gingival and bone necrosis caused by accidental sodium hypochlorite injection instead of anaesthetic solution

To report clinical complications (pain, necrotic gingival tissue and bone sequestration) resulting from accidental injection of sodium hypochlorite. Root canal treatment is a routine clinical procedure with few reported complications. Sodium hypochlorite (NaOCl) is commonly used as an irrigant during the procedure because of its tissue-dissolving, antibacterial and lubricating properties. This paper presents a case in which accidental injection of sodium hypochlorite into the lingual gingiva of a female patient caused gingival and bone necrosis. Surgical intervention was required. *Sodium hypochlorite is dangerous if injected into the tissues. *The presentation of sodium hypochlorite in glass, anaesthetic type cartridges is potentially dangerous, and should be condemned. *All healthcare workers should check carefully the contents of any syringe before injecting into patients.

Measuring up off-shore with effervescent liquids

When specialist engineers PD&MS had to come up with an alternative solution for an unreliable Sodium Hypochlorite injection system on an off-shore platform, they turned to pump and metering specialists Puslafeeder. The company provided a skid with a flowmeter, which would give accurate flow rate readings over pressurisation protection, and two pumpsets, which could adapt the flow to system requirements.

Palatal mucosa necrosis because of accidental sodium hypochlorite injection instead of anaesthetic solution

A case is reported in which sodium hypochlorite (NaOCl) was inadvertently injected into the palatal mucosa instead of local anaesthetic solution. An adult male was referred to the University clinic 15 days after an inadvertent NaOCl injection into the palatal mucosa. Soft tissue necrosis was evident, without obvious bony involvement. Tissues healed without scarring within 30 days. No surgical intervention was required. NaOCl is highly irritant when extruded into vital tissues.--Dentists should be careful to avoid the misuse of NaOCl, and should check the nature of any agent before injecting it into patients.--NaOCl should not be dispensed in a way that could allow it to be mistaken for local anaesthetic solutions.--The well-perfused tissues of the oral cavity have considerable healing ability.

Nitrification preservation in activated sludge during curative bulking chlorination

The bulking that occurs in biological wastewater treatment plants using activated sludge is very often controlled by the injection of sodium hypochlorite into the return activated sludge (RAS) stream. In the present study undertaken at two pilot plants fed with synthetic wastewater, the impact of the pass frequency of the sludge at the chlorine dosing point on the nitrifying flora is analysed. The pass frequency is one for the pilot plant 1 and two for the pilot plant 2. A dose of chlorine of 4.85 +/- 0.05 g/kg/MLVSS per day was applied at both pilots. The preservative effect on nitrifying activity of the lowest concentration of chlorine at the dosing point and therefore of the highest pass frequency was evidenced. Among other tools, a simple method of measurement of the oxygen uptake rate enabled us to monitor the effect of chlorination on nitrification before recording an increase in the ammonia concentration in the bulking.

Direct Sodium Hypochlorite Injection in the Forearm Resulting in Radial Nerve Palsy

Accidental acute exposure to sodium hypochlorite solutions produces a wide spectrum of clinical manifestations [1–6]. However, peripheral mononeuropathy has not been reported. We describe the case of a 14-year-old girl who experienced radial nerve palsy as a result of direct injection of bleach in a suicide attempt. Magnetic resonance imaging (MRI) demonstrated two muscle lesions and disappearance of fat planes around the superficial and deep branches of the radial nerve. The patient’s clinical outcome was favourable, with recovery of radial nerve function. MRI was useful for determining the morphology and extent of the caustic injury.

A Place for Everything, and Everything in its Place!

Accidental Injection of Sodium Hypochlorite Beyond the Root Apex. H. Balto and Al-Nazhan. Saudi Dental Journal 2002; 14: 36–38.

Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex

The effects of an inadvertent injection of sodium hypochlorite into the cheek during irrigation of the right maxillary central incisor root canal are reported. The patient suffered from severe pain, edema, and necrosis of subcutaneous tissues and mucosa. Surgical intervention was necessary to contain the destructive process which extended from the upper lip to the right eye. The histopathological examination demonstrated the high cytotoxicity of sodium hypochlorite on vital tissue.

Sodium hypochlorite injection into periapical tissues

Sodium hypochlorite is a useful adjunct to endodontic therapy but it must be confined to the root canal. A case of periapical injection of hypochlorite with untoward sequellae is presented.