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Accidental injection of EDTA instead of anesthesia solution during root canal treatment: Case report

Balkan Journal of Dental MedicineOctober 17, 2022October 17, 2022

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Eskibağlar Mehmeta, Kaya Sadullaha, Yüzer Güney Mustafaa, Güler Ridvanb, Akin Tartuk Gizema

aDicle University, Department of Endodontics, Diyarbakir, Turkey
bDicle University, Department of Oral and Maxillofacial Surgery, Diyarbakir, Turkey

Summary

Background/Aim: Many irrigation solutions are used during root canal treatment. It is unacceptable to confuse irrigation solutions with anesthetic solution and inadvertently inject the patient. After such an error, local and systemic serious complications can be seen in the patient. The purpose of this case report is to show how careless use of etilendiamin tetraacedic acid (EDTA) can result in important complications, and offer some treatment methods for curing symptoms resulting from such complications. Case Report: A 17% EDTA solution, was inadvertently injected in the buccal mucosa of a 20-year-old male during routine root canal treatment. Severe pain, bleeding and mucosal swelling occurred shortly after the injection. Irrigation with saline was performed by sliding the mucoperiosteal flap at the injection site. Then the flap was sutured primary. At the control one week later, there were no areas of necrosis in the patient, but ecchymosis occurred. Decalcified areas were not detected in dental volumetric tomography examination. Conclusions: The dentists must apply the precautions of EDTA irrigation solution during the root canal treatment and manage the treatment of this clinical complication.

Keywords: accident; endodontics; ethylenediaminetetraacetic acid; local anesthesia; surgery

Reference

Alrahabi, M., Zafar, M.S., Adanir, N. (2019) Aspects of Clinical Malpractice in Endodontics. European Journal of Dentistry, 13: 450-458

Altan, A. (2020) Accidental injection of ethylenediaminetetraacetic acid (EDTA) instead of an anaesthetic solution: A case report. Journal of Stomatology, Oral and Maxillofacial Surgery, 121: 77-79

Chandrasekhar, V., Amulya, V., Rani, V.S., Prakash, T.J., Ranjani, A.S., Gayathri, C. (2013) Evaluation of biocompatibility of a new root canal irrigant Q Mix™ 2 in 1: An in vivo study. J Conserv Dent, 16: 36

Guivarc’h, M., Ordioni, U., Ahmed, H.M.A., Cohen, S., Catherine, J.H., Bukiet, F. (2017) Sodium Hypochlorite Accident: A Systematic Review. Journal of Endodontics, 43: 16-24

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Kaya, S., Ganidağlı, A.S., Uysal, İ., Akkuş, Z. (2011) Comparison of the Impact of Long-Term Applications of MTAD and EDTA Irrigation Agents on Dentin Structure: A Scanning Electron Microscope Study. International Dental Research, 1:60-64

Marins, J.S.R., Sassone, L.M., Fidel, S.R., da Ribeiro (2012) In vitro genotoxicity and cytotoxicity in murine fibroblasts exposed to EDTA, NaOCl, MTAD and citric acid. Brazilian Dental Journal, 23: 527-533

Mohammadi, Z., Shalavi, S., Jafarzadeh, H. (2013) Ethylenediaminetetraacetic acid in endodontics. European Journal of Dentistry, 7:135-142

Motta, M.V., Chaves-Mendonca, M.A.L., Stirton, C.G., Cardozo, H.F. (2009) Accidental injection with sodium hypochlorite: report of a case. International Endodontic Journal, 42: 175-182

Münz, P. (2017) EDTA and 40 years of inventions. Bull Hist Chem, 42: 133-140

Ostby, N. (1957) Chelating in root canal therapy. Ethylenediamine tetraacetic acid for cleansing and widening of root canals. Odontol Tidskr, 65: 3-11

Segura, J.J., Calvo, J.R., Guerrero, J.M., Sampedro, C., Jimenez, A., Llamas, R. (1996) The disodium salt of EDTA inhibits the binding of vasoactive intestinal peptide to macrophage membranes: Endodontic implications. Journal of Endodontics, 227:337-340

Siqueira,, José, F. (2001) Aetiology of root canal treatment failure: Why well-treated teeth can fail. International Endodontic Journal, 34: 1-10

Siqueira, J.F., Rôças, I.N. (2008) Clinical Implications and Microbiology of Bacterial Persistence after Treatment Procedures. Journal of Endodontics, 34:1291-1301

Waknis, P.P., Deshpande, A.S., Sabhlok, S. (2011) Accidental injection of sodium hypochlorite instead of local anesthetic in a patient scheduled for endodontic procedure. Journal of Oral Biology and Craniofacial Research, 1: 50-52

Balkan Journal of Dental Medicine, 2021, vol. 25, br. 3, str. 183-187

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