Application of low-level laser as auxiliary therapeutic of swelling areas caused by apical accidental extrusion of sodium hypochlorite: case report

Abstract

Aim: To discuss an apical accidental extrusion of 2.5% sodium hypochlorite (NaOCl) with assistance of low-level laser. Case Report: A 39-year-old female was referred to the undergradu- ate clinic and during root canal preparation (RCP) reported an immediate burning sensation, which was accompanied by an acute and severe pain. After 3 hours, the patient returned with persistent spontaneous and severe pain in the area of the maxil- lary incisor and pronounced swelling in her upper lip. The diag- nosis hypothesis was accident with extrusion of NaOCl beyond of apex root. The patient immediately received a single oral dose of 8 mg of corticosteroids, and also was prescribed amoxicilin, and anti-inflammatory. To assist the control of inflammation, low level laser therapy was performed. Results: The patient returned 18 hours after the first appointment and the pain and swelling gradually decreased, and although there was extensive ecchy- mosis, no skin necrosis was observed. After 4 days, the patient presented no pain and the swelling area had total remission on day 11. The 17 months follow-up showed clinical aspect with normal appearance. Conclusions: The therapy with antibiotics, anti-inflammatory and LLLT for severe tissue damage caused by NaOCl reduced the severe manifestations of pain and edema.