title: Displaced calcium hydroxide paste causing inferior alveolar nerve paraesthesia: report of a case.
abstract: A patient presented with an intraoral red, painful, and hard swelling in the lower right jaw. Radiographs showed a 2 x 1 cm area of radiopaque material surrounding the apex of the second premolar. The material, according to the patient's dentist, was calcium hydroxide paste used as a temporary dressing material in the root canal. The patient developed paraesthesia in her lower lip probably due to a neurotoxic effect caused by calcium hydroxide. The foreign material was surgically excavated from the spongious bone, directly adjacent to the nerve, and the patient later regained her sensation in the lip. A histopathological analysis revealed necrosis, deposits of foreign bodies, and inflammatory cells and foreign-body giant cells. This report illustrates the toxicity and adjacent clinical symptoms of calcium hydroxide paste when displaced into bone tissue close to the alveolar inferior nerve. It also demonstrates the benefits of removing such displaced material before symptoms progress.
authors.affiliation: Institute of Odontology, Oral and Maxillofacial Surgery, University of Bergen, Norway. fredrik.ahlgren@odont.uib.no
authors.forename: Fredrik K E K
authors.initials: FK
authors.lastname: Ahlgren
authors.forename: Anne Christine
authors.initials: AC
authors.lastname: Johannessen
authors.forename: Sølve
authors.initials: S
authors.lastname: Hellem
mesh_terms: D002126:Calcium Hydroxide / Q000009:adverse effects*; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000473:pathology; D015743:Giant Cells, Foreign-Body / Q000473:pathology; D006801:Humans; D008334:Mandible / Q000473:pathology; D008875:Middle Aged; D009336:Necrosis; D010292:Paresthesia / Q000209:etiology*; D012387:Root Canal Filling Materials / Q000009:adverse effects*; D019227:Tooth Apex / Q000473:pathology; D061221:Trigeminal Nerve Injuries
chemical_list: D012387:Root Canal Filling Materials; D002126:Calcium Hydroxide