Facial hematoma of endodontic origin: A case report

Abstract

Endodontic treatment is a common procedure in dentistry that consists of elimination of organic tissues, infected debris, and pathogenic bacteria from the canal system by means of mechanical instrumentation associated with abundant disinfecting agents (Haapasalo et al., 2005) [1]. Despite progress with its implementation, dentists may at any time be faced with complications during or after a root canal procedure. While some of these problems can be anticipated, many can never really be predicted. A complication such as a hematoma that is usually seen as a complication of trauma or oral surgery, is rarely seen after a simple endodontic treatment. It put the dentist in a confused and uncomfortable situation. Dentists should be aware of the possible occurrence of this incident and should know what can cause it and how to manage it. We report the case of a 63-year-old patient, referred by her general dentist to our center for the sudden onset of a facial hematoma after endodontic treatment.

Keywords: Complications; Endodontic therapy; Hematoma; Root canal treatment; Sodium hypochlorite.

Fig. 1

Extraoral view 1 day after the accident showing left facial oedema and Ecchymosis visible on the periorbital region, the cheek, and the submandibular region.

Fig. 2

Intraoral view showing mild trismus and ecchymosis of labial and buccal mucosa.

Fig. 3

a- Panoramic radiograph before treatment of tooth 26. b- Periapical radiograph done by the general dentist immediately after the canal root obturation and the hematoma incident.

Fig. 4

a and b: Axial views of computed tomography showing the extension of the hematoma to the left facial spaces.

Fig. 5

Follow-up one week after the accident. Note the increase of the ecchymosis in the cheek, but the decreasing of the swelling, and the regression of the periorbital hematoma.

Fig. 6

Follow-up 3 weeks after the accident: Resolution of the hematoma.