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Apex Locators in the diagnosis of perforations
Though I use lot of hypochloride ...hmmm... i am pretty scared about the product . I
wonder how come this product used for washing clothes landed up washing the inside of
people's teeth ! Do you rooters use any standard protocol while using this dangerous /
hazardous product ? I have witnessed a hypochloride incident in my friend's office ..
BOOOO.. it was scary .. the patient's face was all swollen up and it resembled
something like cellulitis ! He was giving predisolone to control the acute
inflammation and he was even expecting larngospasm !
Is it a must that we have to continue using this product or is there any alternative
available ? - Jeevan
From: Bill Watson
Sent: Wednesday, July 04, 2001 2:05 AM
Subject: [roots] Re: the hypochlorite question
It can be a scary product to use. The implications of its misuse can also be alarming
A few (quite obvious) tips to safely using the product are as follows:
Tips For Hypochlorite Use
1-Determine root length prior to using the hypochlorite-using an apex locator can help
determine whether there is a perforation or not.
2-Use a side-vented needle.
3-Place the needle passively into the canal.
4-Slowly and gently place the irrigant in the canal.
5-Make sure the rubber dam fits tightly. Oraseal can be beneficial to help ensure a
good marginal seal.
Most hypochlorite accidents that I have been familiar with are the result of not
having knowledge of root canal length and aggressively injecting and wedging the
needle in the canal. Currently hypochlorite is too important of an adjunct in canal
debridement and disinfection to obviate its use. Being aware of and following the
above tips will prevent an accident. - bill
What is Oraseal? - Bill Watson
Oraseal Caulking is a material for enhancing the seal on your rubber dam and for
sealing leaks on rubber dam - Kim, Ultradent
Oraseal, by Ultradent, is a putty type material that you express around the
margin of the tooth and rubber dam that ensures a good seal, ie, no
hypochlorite down the throat and no saliva leakage. - bill
One additional note. I had a case once with mid root resorption and it did
perforate unbeknown to me. I left hypochlorite in and it actually ate through
tissue laterally. What a surprise when I took off the rubber dam. We
thoroughly rinsed the area with sterile saline and covered the pt with an
antibiotic. The pt healed well but a word of caution to all. Bob
> I had a case once with mid root resorption and it did
> perforate unbeknown to me.
This is certainly where the apex locator would be of help, ie, in detecting
the resorptive perf.
> What a surprise when I took off the rubber dam. We
> thoroughly rinsed the area with sterile saline and covered the pt with an
> antibiotic. The pt healed well but a word of caution to all.
I have not found it a problem to use hypochlorite in resorptive perf cases
as it sounds like you did no either. Hypochlorite does not cause a problem
when coming in CASUAL contact with tissue. It's when it is forced, under
pressure, that an accident will occur - bill
From a paper written some years ago by Sabala, (1988 I think) the hypochlorite
problems seem to be created not by the product itself but from a kind of allergic
reaction. The point being that the amount of hypochlorite expressed out of the tooth
is very small. - Uzi
awesome case.....just blows my mind how caoh works......craig