We present two cases of apical extrusion of non-setting, calcium hydroxide paste which had been placed as
an interappointment root canal dressing during routine endodontic treatment and which resulted in tissue
necrosis of a large part of themandible, while. Surgical intervention consisted of resections in both instances.
In relation to the cases presented, a systematic review of similar cases in the literature between 1980
and April 2013 was conducted which resulted in eight cases meeting the criteria outlined. As with the
two presented cases, half of these eight cases showed serious adverse effects and the use of an injectable
system had most often been related to apical extrusion. Consequently, great care should be taken when
applying the paste into the canal system.
2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights
reserved.