17/10/2024
Calcium Hydroxide.
Careless handling of injectable CaOH can result in its displacement outside of Root Canal System, which may increase the likelihood of Nikolau Syndrome.
Calcium Hydroxide has been used as a disinfectant in endodontic therapy for many years. It also inhibits tooth resorption and induces repair by hard tissue formation. However it comes with risks and complications, including accidental injections in to surrounding vital structures, potentially causing thrombosis, skin necrosis and connective tissue damage.
This patient was referred to Hamad dental center in Qatar. Patient arrived 3 days after Root canal treatment with swelling and hematoma on left cheek, paralysis of left side lips and excessive tearing from left eye.
A CBCT scan revealed dislocation of opaque material from canals of tooth to left maxillary sinus, posterior superior alveolar artery, Infra orbital artery and Infra orbital foramen.
Root canal was completed over 3 visits with corrective plastic surgery.
Main reason found was over preparation of canals and forceful injection of CaOH.
Bites & Braces Dental