Detrimental effect of overextruded nonsetting intracanal calcium hydroxide on gingiva and extraradicular tissue

Abstract

The present case describes the unusual effect of nonsetting calcium hydroxide (CH) when used as an intracanal (IC) medicament for routine endodontic therapy which caused the necrosis of juxtaposed gingival tissue. In this case report, the patient developed a gingival lesion and palatal swelling after root canal therapy (RCT), performed by a general dentist. The swelling was hard and nonfluctuant. The IC medicament deleteriously affected the gingival tissue and periapex, comported as a foreign body, managed by RCT of the left maxillary canine, followed by periapical surgery for the removal of overextruded CH and cyst enucleation. On a 2-week follow-up, gingival tissue and palatal swelling healed completely. On 7-month follow-up, periapical tissue had achieved radiographic normalcy. In conclusion, a routine IC medicament may deleteriously affect the gingival tissue and periapex, comporting as a foreign body. Therefore, the selection and the application of medicament must be done cautiously.

Keywords

• calcium hydroxide
• gingival necrosis
• overextrusion
• radicular cyst