A Remarkable Rare Case of Fractured Endodontic Instrument in Periradicular Region Compressing Inferior Alveolar Nerve


Affiliations

  • Maulana Azad Institute of Dental Sciences, Department of Oral and Maxillofacial Surgery, Delhi, India
  • Maulana Azad Institute of Dental Sciences, Department of Conservative Dentistry and Endodontics, Delhi, India

Abstract

This study aims to present the management of a rare case of a separated endodontic instrument in the periradicular area. The broken instrument had penetrated within and along the mandibular canal from the periapical zone of mandibular second molar after endodontic treatment, leading to acute neurological symptoms. These subsided completely following surgical removal of the separated instrument. Because of the close anatomic relation between the second molars and the inferior alveolar nerve, careful clinical and radiographic examinations should always be performed before endodontic treatment of these teeth, so as to prevent iatrogenic injuries of the type described here. Dentists should also be aware of the anatomic characteristics of the mandibular canal (i.e., cribriform rather than solid), as well as the consequences of overinstrumentation.

Keywords

Paresthesia, Separated, Mandibular Canal, Inferior Alveolar Nerve, Overinstrumentation.

Subject Discipline

Dentistry

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References

Poveda R, Baga´n JV, Diaz Ferna´ndez JM, Sanchis JM. Mental nerve paresthesia associated with endodontic paste within the mandibular canal: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102:e46–9.

Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: A review. Int Endod J 2002; 35:127-141.

Kafas P, Upile T, Angouridakis N, Stavrianos C, Dabarakis N, Jerjes W. Dysaesthesia in the mental nerve distribution triggered by a foreign body: A case report. Cases J 2009; 2:169-169.

Orstravic D, Brodin P, Ass E. Paresthesia following endodontic treatment: Survey of the literature and report of a case. Int Endod J 1983; 16:167-172.

Allantar A, Tarragano H, Levevre B. Extrusion of endodontic filling material into the insertions of the mylohyoid muscle. Oral Surg Oral Med Oral Pathol 1994; 78: 646-649.

Merskey H, Bogduk N. IASP Task Force on Taxonomy. Classification of chronic pain. 2nd ed. Seattle: IASP Press; 1994.p.209-14.

Zeigler PE, Serene TP. Failure in Therapy. In Cohen, S. and R.C. Burns editors. Pathways of the Pulp. 3rd ed. St Louis: CV Mosby Co; 1984.p. 786-819.

Brkic A, Gurkan-Koseoglu B, Olgac V. Surgical approach to iatrogenic complications of endodontic therapy: A report of 2 cases. Oral Surg. Oral Med Oral Pathol Oral Radiol Endod 2009; 107:50-53.

Gallas-Torreira MM, Reboiras-Lopez MD, Garcia-Garcia A, Gandara-Rey J. Mandibular nerve paresthesia caused by endodontic treatment. Med Oral 2003; 8(4):299-303.

Köseoglu BG, TanrIkulu S, Sübay RK, Sencer S. Anesthesia following overfilling of a root canal sealer into the mandibular canal: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(6):803-6.

Pogrel MA. Damage to the inferior alveolar nerve as the result of root canal therapy. J Am Dent Assoc 2007; 138(1):65-9.

Knowles KI, Jergenson MA, Howard JH. Paresthesia associated with endodontic treatment of mandibular premolars. J Endod 2003; 29(11):768-70.

Fanibunda K, Whitworth J, Steele J. The management of thermomechanically compacted gutta percha extrusion in the inferior dental canal. Br Dent J 1998; 184(7):330-2.

Tilotta-Yasukawa F, Millot S, El Haddioui A, Bravetti P, Gaudy JF. Labiomandibular paresthesia caused by endodontic treatment: an anatomic and clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102(4):e47-59.

Di Lenarda R, Cadenaro M, Stacchi C. Paresthesia of the mental nerve induced by periapical infection: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90(6):746-9.


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