Formation of a facial hematoma during endodontic therapy

J Am Dent Assoc. 2000 Jan;131(1):67-71. doi: 10.14219/jada.archive.2000.0021.


Background: Sodium hypochlorite, or NaOCl, is one of the most commonly used irrigating solutions in endodontic practice. Its clinically proven antibacterial, solvent and lubricating properties make it a very appealing choice as an intracanal medicament.

Case description: The authors present a case of facial hematoma formation after an inadvertent injection of NaOCl into the periapical tissues. The NaOCl solution caused extensive tissue destruction. Management of the condition required the hospitalization, intravenous antibiotic therapy and multiple intraoral surgical incisions to facilitate drainage.

Clinical implications: Use of NaOCl must be confined to the root canal system. This report reviews this intracanal medicament's potential toxicity and emphasizes the need for clinicians to remain cognizant of possible problems while using the solution.

Publication types

  • Case Reports

MeSH terms

  • Cellulitis / etiology
  • Cuspid / surgery
  • Ecchymosis / etiology
  • Face
  • Female
  • Hematoma / etiology*
  • Hematoma / surgery
  • Humans
  • Medical Errors / adverse effects
  • Middle Aged
  • Orbital Diseases / chemically induced
  • Periapical Tissue / drug effects*
  • Periapical Tissue / surgery
  • Root Canal Irrigants / adverse effects*
  • Root Canal Obturation / adverse effects*
  • Sodium Hypochlorite / adverse effects*


  • Root Canal Irrigants
  • Sodium Hypochlorite