A COMPARATIVE ANALYSIS ON THE FREQUENCY, MANAGEMENT, AND PREVENTIVE MEASURES OF SODIUM HYPOCHLORITE ACCIDENTS DURING ROOT CANAL TREATMENT IN PUBLIC AND PRIVATE DENTAL INSTITUTIONS IN PUNJAB, PAKISTAN

Abstract

Background: Sodium hypochlorite (NaOCl) is the irrigant of choice in endodontic therapy; however, extrusion beyond the apex can cause severe soft tissue injury causing complications in treatment.

Objective: To access the frequency of hypochlorite accidents, their management and preventive measures during root canal treatment in private and public dental institutes in Punjab, Pakistan..

Material and Methods: This cross-sectional study was conducted from Dec 22 to Aug24 in 2 private i.e., Azra Naheed Dental Hospital and University College of Dentistry and 1 public dental hospital i.e., de’ Montmorency College of Dentistry. Dentists and house officers working in operative department participated by completing a validated 10-item online questionnaire developed and validated by the authors. Data was analyzed by using SPSS v24using Chi square test.

Results: Out of 359 participants, 342 (95.3%) reported NaOCl accident at least once, with significantly higher frequency in private hospitals (p=0.006). There were 288 (69.9%) females and 124 (30.1%) males. The most common accident was extrusion beyond the apex (n=120, 35.2%), followed by soft tissue infiltration (n=62, 18.1%), and ingestion (n=54, 15.8%). Ingestion was more frequent in public hospitals (p<0.001). Pain (n=292, 85.7%), swelling (n=234, 68.4%), and erythematic (n=260, 75.9%) were more common in public hospitals. Preventive measures like low-concentration NaOCl was more practiced in public hospitals (p=0.011), while rubber dam (p=0.024) and side-vented needles (p=0.003) were more practiced in private hospitals.

Conclusion: NaOCl accidents were prevalent in Punjab, with notable differences in frequency, prevention, and management between sectors. Standardized protocols and targeted training are needed to improve patient safety.