Clinical Characteristics and Predictors of Chemical Irrigant-Related Soft Tissue Injuries in Endodontic Practice: A...

Sodium hypochlorite (NaOCl) is frequently employed in endodontic procedures; however, improper application can result in significant soft tissue damage. This study investigated the incidence, characteristics, and outcomes of complications associated with NaOCl and identified contributing factors such as the operator's level of expertise, timing of intervention, and treatment modality.

A retrospective analysis was conducted on 60 patients who sustained soft tissue injuries due to sodium hypochlorite; additionally, a minority of non-NaOCl agents (lidocaine, chlorhexidine, and articaine) were included for comparison between 2018 and 2023. The study recorded demographic data, procedure type, operator status, injury severity, and treatment methods. Statistical comparisons were performed using chi-square and Fisher's exact tests.

The mean age of the patients was 36.4 ± 11.2 years, with a female representation of 65%. Root canal therapy accounted for 73.3% of the cases. Sodium hypochlorite was responsible for 53.3% of the injuries and was significantly associated with necrosis (43.7%) and scarring (75%, P=.019). Dental students exhibited higher complication rates compared to experienced operators (P=.032). Early intervention, defined as occurring within 24 hours, was associated with a reduced risk of permanent damage (18% vs. 62%, P=.004). Surgical management resulted in improved outcomes, with 80% of operated cases showing improvement. The mean follow-up period was 6.8 months.

Sodium hypochlorite-induced soft tissue injuries can result in enduring functional and aesthetic consequences. Early detection, operator proficiency, and timely intervention are crucial for enhancing patient outcomes. These findings advocate for the implementation of preventive protocols and the enhancement of endodontic training.