Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Hypoesthesia after IAN block anesthesia with lidocaine: management of mild to moderate nerve injury

  • Moon, Sungjoo (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Lee, Seung-Jong (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Kim, Euiseong (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Lee, Chan-Young (Department of Conservative Dentistry, Yonsei University College of Dentistry)
  • Received : 2012.08.06
  • Accepted : 2012.10.08
  • Published : 2012.12.01
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Abstract

Hypoesthesia after an inferior alveolar nerve (IAN) block does not commonly occur, but some cases are reported. The causes of hypoesthesia include a needle injury or toxicity of local anesthetic agents, and the incidence itself can cause stress to both dentists and patients. This case presents a hypoesthesia on mental nerve area followed by IAN block anesthesia with 2% lidocaine. Prescription of steroids for a week was performed and periodic follow up was done. After 1 wk, the symptoms got much better and after 4 mon, hypoesthesia completely disappeared. During this healing period, only early steroid medication was prescribed. In most cases, hypoesthesia is resolved within 6 mon, but being aware of etiology and the treatment options of hypoesthesia is important. Because the hypoesthesia caused by IAN block anesthesia is a mild to moderate nerve injury, early detection of symptom and prescription of steroids could be helpful for improvement of the hypoesthesia.

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References

  1. Lichtor T, Mullan JF. A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 1990;72:49-54.
  2. Hillerup S, Jensen RH, Ersbøll BK. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity? J Am Dent Assoc 2011; 142:531-539.
  3. Haas DA, Lennon D. A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc 1995;61:319-320, 323-326, 329-330.
  4. Krafft TC, Hickel R. Clinical investigation into the incidence of direct damage to the lingual nerve caused by local anaesthesia. J Craniomaxillofac Surg 1994; 22:294-296.
  5. Dower JS Jr. Anesthetic study questioned. J Am Dent Assoc 2007;138:708, 710; author reply 710, 712.
  6. Pogrel MA, Thamby S. Permanent nerve involvement resulting from inferior alveolar nerve blocks. J Am Dent Assoc 2000;131:901-907.
  7. Pogrel MA, Bryan J, Regezi J. Nerve damage associated with inferior alveolar nerve blocks. J Am Dent Assoc 1995;126:1150-1155.
  8. Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc 2002;68:546-551.
  9. Reina MA, Lopez A, De Andres JA, Maches F. Possibility of nerve lesions related to peripheral nerve blocks. A study of the human sciatic nerve using different needles. Rev Esp Anestesiol Reanim 2003;50:274-283.
  10. Garisto GA, Gaffen AS, Lawrence HP, Tenenbaum HC, Haas DA. Occurrence of paresthesia after dental local anesthetic administration in the United States. J Am Dent Assoc 2010;141:836-844.
  11. Kirihara Y, Saito Y, Sakura S, Hashimoto K, Kishimoto T, Yasui Y. Comparative neurotoxicity of intrathecal and epidural lidocaine in rats. Anesthesiology 2003;99:961-968.
  12. Gaffen AS, Haas DA. Retrospective review of voluntary reports of nonsurgical paresthesia in dentistry. J Can Dent Assoc 2009;75:579.
  13. Omer GE Jr. Methods of assessment of injury and recovery of peripheral nerves. Surg Clin North Am 1981; 61:303-319.
  14. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain 1951;74:491-516.
  15. Seddon HJ, Medawar PB, Smith H. Rate of regeneration of peripheral nerves in man. J Physiol 1943;102:191-215.
  16. Lagalla G, Logullo F, Di Bella P, Provinciali L, Ceravolo MG. Influence of early high-dose steroid treatment on Bell's palsy evolution. Neurol Sci 2002;23:107-112.
  17. Austin JR, Peskind SP, Austin SG, Rice DH. Idiopathic facial nerve paralysis: a randomized double blind controlled study of placebo versus prednisone. Laryngoscope 1993;103:1326-1333.
  18. Wray SH. Optic neuritis: guidelines. Curr Opin Neurol 1995;8:72-76.
  19. Ramsey MJ, DerSimonian R, Holtel MR, Burgess LP. Corticosteroid treatment for idiopathic facial nerve paralysis: a meta-analysis. Laryngoscope 2000;110:335-341.
  20. Seo K, Tanaka Y, Terumitsu M, Someya G. Efficacy of steroid treatment for sensory impairment after orthognathic surgery. J Oral Maxillofac Surg 2004;62: 1193-1197.
  21. Lewis MA, Sankar V, De Laat A, Benoliel R. Management of neuropathic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:S32.e1-24.
  22. Park JH, Lee SH, Kim ST. Pharmacologic management of trigeminal nerve injury pain after dental implant surgery. Int J Prosthodont 2010;23:342-346.

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