Volume 2 - Issue 3 (May-Jul)

Sodium Hypochlorite Solution Enhances Healing of Periapical
Lesion by Nonsurgical Method
Subrata Sarkar *, Soumyabrata Sarkar**, Badruddin Ahmed Bazmi † , Sarbani Ghosh ‡
case report
Abstract
Sodium hypochlorite (NaOC1) is a broad-spectrum antimicrobial agent effective against bacteria, spores, yeast and viruses.
It provides 100% bacterial reduction as it contains 50 ppm available chlorine at 6.7-10.7 pH at 20 0 C in one minute. 5.25%
NaOCl solution has a pH 11-12 and it provides immediate antibacterial action during root canal irrigation. 2.5-3% solution
has a pH of 11-12, which also gives good results. Grossman (1978) and others observed healing of large periapical lesions
by nonsurgical methods using NaOC1 solution, though the exact mechanism of healing is not clear but it is proved that
NaOC1 has good action against bacteria.
Key words: Sodium hypochlorite, root canal irrigation, nonsurgical method
Periapical infection of tooth/teeth is one of the
common problems in young children. Various
factors are responsible for this, of which caries and
trauma are the prime causes. Neglected trauma causes
apical swelling, pain and swallowing problem, which
are the common signs. 1-5 Radiologic examination shows
large radiolucent areas in relation to affected tooth,
which may be an apical abscess, granuloma or cyst.
Gram-positive anaerobic bacteria are cultured and gramnegetive
anaerobic bacteria cause pathological change
in the apical region. This lesion has a connection with
root canals of the tooth. Various types of treatments
have been advocated to overcome this problem such as
root canal treatment along with surgical curettage in
the apical region. 6
Recently, various investigators 7-13 suggested a
nonsurgical treatment procedure, which will control
apical infection and promote healing of large periapical
lesions. Present paper reflects the management of
a periapical lesion of a young boy by a nonsurgical
method.
*Professor and Head, Dept. of Pedo-Preventive Dentistry
**Senior Lecturer, Dept. of Oral Diagnosis
Oral Medicine and Oral Radiology
†
Senior Lecturer, Dept. of Pedo-Preventive Dentistry
‡
Clinical Tutor, Dept. of Community Dentistry
Guru Nanak Institute of Dental Sciences and Research, Panihati, Kolkata
Address for correspondence
Dr Subrata Sarkar
7, PC Ghosh Road Kolkata - 700 048
E-mail: drssarkar44@yahoo.com
Case Report
A 12-year-young boy came with complaints of pain
and swelling in 41, 42 region for last seven days.
He gave history of trauma in 41, 42 region one year
back. Recently, he developed sudden apical swelling
along with pain, fever, lymphadenitis. After proper
antibiotics, anti-inflammatory and mouth rinse history
of pain and fever subsided.
Investigation: Intraoral periapical X-ray in 41, 42
region was advised. Which showed large radiolucent
area in the region (Fig. 1).
Provisional diagnosis: Chronic periapical abscess in
41, 42 region.
Treatment plan: Nonsurgical endodontic treatment
approach.
Treatment procedure: Thermal and electrical pulp
testing was done in 41, 42 region, which failed to
respond indicating nonvital teeth. The access cavity
was prepared with the help of Round-end Fissure
Bur. Canal was kept open for 24 hours to drain out
pus from the canal. After 24 hours, 5.25% sodium
hypochlorite (NaOC1) irrigation was done drop by
drop slowly (Fig. 2).
After 48 hours, with the help of protaper, enlargement
and removal of root canal debris was done. Then again
irrigation was done with 5.25% NaOCl. Access cavity
was sealed with Cavit cement (3M). Same procedure
Indian Journal of Multidisciplinary Dentistry, Vol. 2, Issue 3, May-July 2012
529