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Chhabra A, Chhabra N. Inferior alveolar nerve paraestheia and cutaneous sinus on the face associated with periapical infection of lower molar teeth in a 14-year-old girl: A rare and unusual case report. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2020; 32:19-24. [PMID: 32538876 DOI: 10.3233/jrs-200025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Paresthesia is defined as a burning or prickling sensation or partial numbness caused by neural injury. OBJECTIVE The purpose of this paper is to present a rare and unusual case report of odontogenic infection-induced inferior alveolar nerve (IAN) paresthesia along with cutaneous draining sinus on the face of a pediatric patient and to discuss the possible pathophysiologic mechanism of nerve injury. METHODS A 14-year-old female patient with cutaneous sinus and paresthesia associated with inferior alveolar nerve was enrolled in the study and the clinical and radiological manifestations of sinus lesion were carefully evaluated. RESULTS The most appropriate treatment was carried out not only to resolve extraoral sinus but also to ensure progressive healing for the complete resolution of neurological disturbance. CONCLUSION The simultaneous occurrence of infection and paresthesia strongly suggested a definitive relationship. Therefore, there seems to be a correlation between duration, origin, significance of the injury and the prognosis of paresthesia.
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Affiliation(s)
- Anuj Chhabra
- Department of Dental Surgery, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, Malkaganj, New Delhi, India
| | - Nidhi Chhabra
- Department of Dental Surgery, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, Malkaganj, New Delhi, India
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Dalopoulou A, Economides N, Evangelidis V. Extrusion of Root Canal Sealer in Periapical Tissues - Report of Two Cases with Different Treatment Management and Literature Review. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case.
Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed.
Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.
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Affiliation(s)
- Athina Dalopoulou
- Undergraduate student, Aristotle University, Dental School, Thessaloniki, Greece
| | - Nikolaos Economides
- Associate Professor, Aristotle University, Dental School, Thessaloniki, Greece
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Infection Related Inferior Alveolar Nerve Paresthesia in the Lower Premolar Teeth. Case Rep Dent 2016; 2016:2623507. [PMID: 27597904 PMCID: PMC4997022 DOI: 10.1155/2016/2623507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 07/24/2016] [Accepted: 07/25/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction. The aim of this paper was to describe two cases of IAN infection-induced paresthesia and to discuss the most appropriate treatment solutions. Methods. For two patients, periapical lesions that induced IAN paresthesia were revealed. In the first case, the tooth was previously endodontically treated, whereas in the second case the lesion was due to pulp necrosis. Results. For the first patient, a progressive healing was observed only after the tooth extraction. In the second patient, the paresthesia had resolved after endodontic treatment. Conclusions. The endodontic-related paresthesia is a rare complication that can be the result of a combination of etiopathogenic mechanisms such as mechanical pressure on the nerve fibers due to the expanding infectious process and the production of microbial toxins. Paresthesia resulting from periapical lesions usually subsides through elimination of infection by root canal treatment. However, if there are no signs of enhancement, the immediate extraction of the tooth is the treatment of choice in order to prevent irreversible paresthesia because it was demonstrated that there is a correlation between the duration of mechanical or chemical irritation and the risk of permanent paresthesia.
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Kim JE, Cho JB, Yi WJ, Heo MS, Lee SS, Choi SC, Huh KH. Accidental overextension of endodontic filling material in patients with neurologic complications: a retrospective case series. Dentomaxillofac Radiol 2016; 45:20150394. [PMID: 26915406 DOI: 10.1259/dmfr.20150394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Accidental overextension of filling material during endodontic treatment may cause mechanical and chemical irritation of the adjacent tissue. In this case series, seven patients who complained of neurologic complication after overextension of canal filling material during endodontic treatment were presented. Overextensions of filling material into the surrounding tissues, such as the mandibular canal, bone marrow, and submucosal layer, were confirmed with panoramic radiograph and computed tomographic images. When patients complain of neurological disturbances after root canal treatment, proper radiographic images should be taken to verify any overextension of materials and to determine the specific location of the overfilled materials.
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Affiliation(s)
- Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jun-Bum Cho
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Coskunses FM, Sinanoglu A, Helvacioglu-Yigit D, Abbott PV. The extrusion of root canal cement containing paraformaldehyde into the inferior alveolar nerve canal resulting in infection and numbness. Int Endod J 2015; 49:610-617. [DOI: 10.1111/iej.12510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/14/2015] [Indexed: 12/13/2022]
Affiliation(s)
- F. M. Coskunses
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Kocaeli University; Kocaeli Turkey
| | - A. Sinanoglu
- Department of Oral and Maxillofacial Radiology; Faculty of Dentistry; Kocaeli University; Kocaeli Turkey
| | - D. Helvacioglu-Yigit
- Department of Endodontics; Faculty of Dentistry; Kocaeli University; Kocaeli Turkey
| | - P. V. Abbott
- School of Dentistry; University of Western Australia; Nedlands Western Australia Australia
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Bosch-Aranda ML, Canalda-Sahli C, Figueiredo R, Gay-Escoda C. Complications following an accidental sodium hypochlorite extrusion: A report of two cases. J Clin Exp Dent 2012; 4:e194-8. [PMID: 24558554 PMCID: PMC3917647 DOI: 10.4317/jced.50767] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 01/05/2012] [Indexed: 11/27/2022] Open
Abstract
Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae.
This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.
Key words:Nerve damage, root canal irrigation, root canal treatment, sodium hypochlorite.
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Affiliation(s)
- María L Bosch-Aranda
- DDS. Fellow of the Postgraduate Oral Surgery and Orofacial Implantology, School of Dentistry, University of Barcelona (Spain)
| | - Carlos Canalda-Sahli
- DDS, MD, PhD. Professor of Endodontics, School of Dentistry, University of Barcelona (Spain). Researcher of the IDIBELL Institute. Barcelona (Spain)
| | - Rui Figueiredo
- DDS. Associate Professor of Oral Surgery. Professor of the Master of Oral Surgery and Orofacial Implantology. School of Dentistry of the University of Barcelona. Researcher of the IDIBELL Institute. Barcelona (Spain)
| | - Cosme Gay-Escoda
- DDS, MD, PhD. Chairman and Professor of Oral and Maxillofacial Surgery. Director of the Master of Oral Surgery and Orofacial Implantology. School of Dentistry of the University of Barcelona. Coordinator/Researcher of the IDIBELL Institute. Oral and Maxillofacial Surgeon of the Teknon Medical Center, Barcelona (Spain)
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Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal. J Endod 2010; 36:1419-21. [PMID: 20647109 DOI: 10.1016/j.joen.2010.03.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2010] [Revised: 02/27/2010] [Accepted: 03/01/2010] [Indexed: 12/21/2022]
Abstract
The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal.
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Brkić A, Gürkan-Köseoğlu B, Olgac V. Surgical approach to iatrogenic complications of endodontic therapy: A report of 2 cases. ACTA ACUST UNITED AC 2009; 107:e50-3. [DOI: 10.1016/j.tripleo.2009.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 12/31/2008] [Accepted: 01/07/2009] [Indexed: 11/24/2022]
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Inferior Alveolar Nerve Damage Because of Overextended Endodontic Material: A Problem of Sealer Cement Biocompatibility? J Endod 2007; 33:1484-9. [DOI: 10.1016/j.joen.2007.09.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 09/02/2007] [Accepted: 09/04/2007] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Endodontic treatment of mandibular molar teeth has the potential to damage the inferior alveolar nerve via direct trauma, pressure or neurotoxicity. METHODS The author reviewed all cases of involvement of the inferior alveolar nerve resulting from root canal therapy in patients seen in a tertiary referral center during an eight-year period (1998 through 2005). The author had encouraged practitioners to refer patients immediately to a university clinic. RESULTS The author saw 61 patients during the eight-year period. Eight patients were asymptomatic and received no treatment. Forty-two patients exhibited only mild symptoms or were seen more than three months after undergoing root canal therapy, and they received no surgical treatment. Only 10 percent of these patients experienced any resolution of symptoms. Eleven patients underwent surgical exploration. Five of these patients underwent exploration and received treatment within 48 hours, and all recovered completely. The remaining six patients underwent surgical exploration and received treatment between 10 days and three months after receiving endodontic therapy. Of these patients, four experienced partial recovery and two experienced no recovery at all. CONCLUSIONS Early surgical exploration and débridement may reverse the side effects of endodontic treatment on the inferior alveolar nerve. CLINICAL IMPLICATIONS If the radiograph obtained after endodontic therapy shows sealant in the inferior alveolar canal, then immediate referral to an oral and maxillofacial surgeon is indicated if the patient has continued symptoms of paresthesia or pain once the local anesthetic should have worn off. Immediate surgical exploration and débridement may provide satisfactory results.
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Affiliation(s)
- M Anthony Pogrel
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, P.O. Box 0440, 521 Parnassus Ave., Room C-522, San Francisco, CA 94141-0440, USA.
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Poveda R, Bagán JV, Fernández JMD, Sanchis JM. Mental nerve paresthesia associated with endodontic paste within the mandibular canal: report of a case. ACTA ACUST UNITED AC 2006; 102:e46-9. [DOI: 10.1016/j.tripleo.2006.03.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2005] [Revised: 03/18/2005] [Accepted: 03/20/2006] [Indexed: 10/24/2022]
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Köseoğlu BG, Tanrikulu S, Sübay RK, Sencer S. Anesthesia following overfilling of a root canal sealer into the mandibular canal: A case report. ACTA ACUST UNITED AC 2006; 101:803-6. [PMID: 16731404 DOI: 10.1016/j.tripleo.2005.07.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 07/04/2005] [Accepted: 07/06/2005] [Indexed: 10/25/2022]
Abstract
The surgical treatment of a case of anesthesia that occurred with the extrusion of Endomethasone root canal sealer into the mandibular canal is presented. Endomethasone is a neurotoxic root canal sealer containing paraformaldehyde and eugenol. The literature indicates immediate surgical decompression on the extrusion of Endomethasone into the mandibular canal. In our case, the decompression surgery was done 3 weeks after the endodontic mishap. The nearly complete resolution of anesthesia 4 months following the decompression surgery suggests that the neurotoxic effects of Endomethasone are still reversible after 3 weeks.
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Affiliation(s)
- Banu Gürkan Köseoğlu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul University, Turkey.
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Yatsuhashi T, Nakagawa KI, Matsumoto M, Kasahara M, Igarashi T, Ichinohe T, Kaneko Y. INFERIOR ALVEOLAR NERVE PARESTHESIA RELIEVED BY MICROSCOPIC ENDODONTIC TREATMENT. THE BULLETIN OF TOKYO DENTAL COLLEGE 2003; 44:209-12. [PMID: 15103918 DOI: 10.2209/tdcpublication.44.209] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.
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Affiliation(s)
- Takaaki Yatsuhashi
- Department of Endodontics, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan
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Conrad SM. Neurosensory Disturbances as a Result Of Chemical Injury to the Inferior Alveolar Nerve. Oral Maxillofac Surg Clin North Am 2001. [DOI: 10.1016/s1042-3699(20)30142-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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