Halil İbrahim DURMUŞ, Mehmet Sait ŞİMŞEK, Tevfik KIZILSEKİ, Kağan Fatih KUŞAN
Journal of Dental Sciences and Education - 2026;4(3):124-127
Calcium hydroxide, a commonly used intracanal medication in endodontic treatment, can lead to serious bone and soft tissue damage if it is extruded uncontrollably. This case report describes the surgical management of extensive tissue necrosis resulting from the extrusion of a calcium hydroxide paste containing barium sulfate. A fourteen-year-old female patient presented with severe pain and diffuse, firm swelling in the posterior right mandibular region after root canal treatment. Cone beam computed tomography revealed that the extruded material extended beyond the lingual cortex into the submandibular space, causing bone destruction; however, the inferior alveolar nerve was spared. Surgical treatment included removal of the extruded material, debridement of necrotic tissue, and extraction of the affected tooth. Histopathological examination revealed necrosis and a foreign body reaction. No complications occurred during the postoperative period. This case demonstrates that serious tissue destruction can occur even without nerve damage and highlights the importance of early surgical interventions.
