Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy.
Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN) resulting in disabling sensory disturbances such as pain, dysesthesia, paresthesia, hypoesthesia, or anesthesia. Two fundamental mechanisms are responsible for the injury: the chemical neurotoxicity and the mechanical compression caused by the extruded material. Although spontaneous resorption has been described for some materials, early surgical exploration with removal of the material and decompression of the IAN should be performed, irrespective of the material used, given that the importance of nerve damage increases with the duration of the injury. We report 4 cases of disabling dysesthesia and paresthesia following endodontic treatment of lower molars in which sagittal osteotomy was used to remove the endodontic paste and to perform nerve decompression. All the patients experienced immediate relief of dysesthesia and paresthesia.
Scolozzi
Paolo
P
Department of Otolaryngology/Head and Neck Surgery, Division of Oral and Maxillofacial Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. scolozzi@hotmail.com
Lombardi
Tommaso
T
Jaques
Bertrand
B
D000328:Adult; D000368:Aged; D001729:Bismuth / Q000009:adverse effects; D019299:Decompression, Surgical; D004338:Drug Combinations; D004853:Epoxy Resins / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006171:Gutta-Percha / Q000009:adverse effects; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008340:Mandibular Nerve / Q000187:drug effects / Q000601:surgery*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010292:Paresthesia / Q000209:etiology / Q000601:surgery*; D012387:Root Canal Filling Materials / Q000009:adverse effects; D012389:Root Canal Obturation / Q000009:adverse effects*; D012834:Silver / Q000009:adverse effects; D014025:Titanium / Q000009:adverse effects; D061221:Trigeminal Nerve Injuries
D004338:Drug Combinations; D004853:Epoxy Resins; D012387:Root Canal Filling Materials; D012834:Silver; C028044:epoxy resin AH-26; D006171:Gutta-Percha; D014025:Titanium; D001729:Bismuth