title: Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report.
abstract: During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.
authors.affiliation: Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Yooseok
authors.identifier: 0000-0003-1121-2570
authors.initials: Y
authors.lastname: Shin
authors.affiliation: Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Byoung-Duck
authors.identifier: 0000-0001-5219-938X
authors.initials: BD
authors.lastname: Roh
authors.affiliation: Department of Conservative Dentistry, Ewha Womans University, Seoul, Korea.
authors.forename: Yemi
authors.identifier: 0000-0002-8280-3805
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Taehyeon
authors.identifier: 0000-0002-7177-9483
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Hyungjun
authors.identifier: 0000-0002-3364-9995
authors.initials: H
authors.lastname: Kim
keywords: Calcium hydroxide; Extrusion; Inferior alveolar nerve; Neurotoxic effects; Surgical debridement