Journal of The Korean Dental Society of Anesthesiology (대한치과마취과학회지)

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지

Peripheral Nerve Injuries Related to Local Dental Clinic Anesthesia in the Dental Clinic

치과에서 발생하는 국소마취에 의한 신경손상

  • Kim, Hyun Jeong (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University)
  • 김현정 (서울대학교 치의학대학원 치과마취과학교실)
  • Received : 2014.06.30
  • Accepted : 2014.07.04
  • Published : 2014.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

Keywords

References

  1. Campbell RL, Shamaskin RG, Harkins SW: Assessment of recovery from injury to inferior alveolar and mental nerves. Oral Surg Oral Med Oral Pathol 1987; 64(5): 519-26. https://doi.org/10.1016/0030-4220(87)90024-7
  2. Nickel AA: A retrospective study of paresthesia of the dental alveolar nerves. Anesth Prog 1990; 37(1): 42-5.
  3. 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(5): 294-6. https://doi.org/10.1016/S1010-5182(05)80079-4
  4. Haas DA, Lennon D: A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc 1995; 61(4): 319-20, 23-6, 29-30.
  5. Lustig JP, Zusman SP: Immediate complications of local anesthetic administered to 1,007 consecutive patients. J Am Dent Assoc 1999; 130(4): 496-9. https://doi.org/10.14219/jada.archive.1999.0243
  6. Http://Blog.Naver.Com/Aozora413/60171252618.
  7. Robinson PP, Loescher AR, Smith KG: A prospective, quantitative study on the clinical outcome of lingual nerve repair. Br J Oral Maxillofac Surg 2000; 38(4): 255-63. https://doi.org/10.1054/bjom.2000.0463
  8. Pogrel MA, Thamby S: The etiology of altered sensation in the inferior alveolar, lingual, and mental nerves as a result of dental treatment. J Calif Dent Assoc 1999; 27(7): 531, 4-8.
  9. Assael LA: The nerve under the microscope. J Oral Maxillofac Surg 2002; 60(5): 483-4. https://doi.org/10.1053/joms.2002.33236
  10. Sh S: Surgical disorders of the peripheral nerves. London, hurchill Livingstone. 1975.
  11. Ss S: Nerve injuries and their repair. London, Churchill Livingstone. 1991.
  12. Kirihara Y, Saito Y, Sakura S, Hashimoto K, Kishimoto T, Yasui Y: Comparative neurotoxicity of intrathecal and epidural lidocaine in rats. Anesthesiology 2003; 99(4): 961-8. https://doi.org/10.1097/00000542-200310000-00032
  13. Colin W, Donoff RB: Restoring sensation after trigeminal nerve injury: a review of current management. J Am Dent Assoc 1992; 123(12): 80-5.
  14. Day RH: Diagnosis and treatment of trigeminal nerve injuries. J Calif Dent Assoc 1994; 22(6): 48-51, 3-4.
  15. Hutchings ML: Nerve damage and nerve blocks. J Am Dent Assoc 1996; 127(1): 25. https://doi.org/10.14219/jada.archive.1996.0013
  16. Pogrel MA, Kaban LB: Injuries to the inferior alveolar and lingual nerves. J Calif Dent Assoc 1993; 21(1): 50-4.
  17. Crean SJ, Powis A: Neurological complications of local anaesthetics in dentistry. Dent Update 1999; 26(8): 344-9. https://doi.org/10.12968/denu.1999.26.8.344
  18. Ruggiero SL: Trigeminal nerve injury and repair. N Y State Dent J 1996; 62(8): 36-40.
  19. Gratt BM, Shetty V, Saiar M, Sickles EA: Electronic thermography for the assessment of inferior alveolar nerve deficit. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80(2): 153-60. https://doi.org/10.1016/S1079-2104(05)80194-5
  20. Costa FW, Fontenele EH, Bezerra TP, Ribeiro TR, Carneiro BG, Soares EC: Correlation between radiographic signs of third molar proximity with inferior alveolar nerve and postoperative occurrence of neurosensory disorders: a prospective, double-blind study. Acta Cir Bras 2013; 28(3): 221-7. https://doi.org/10.1590/S0102-86502013000300011
  21. Poort LJ, Van Neck JW, Van Der Wal KG: Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies. J Oral Maxillofac Surg 2009; 67(2): 292-300. https://doi.org/10.1016/j.joms.2008.06.076
  22. Takasugi Y, Furuya H, Moriya K, Okamoto Y: Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen. Anesth Prog 2000; 47(4): 125-9.
  23. Haas DA, Lennon D: Local anesthetic use by dentists in Ontario. J Can Dent Assoc 1995; 61(4): 297-304.
  24. Zuniga JR, Labanc JP: Advances in microsurgical nerve repair. J Oral Maxillofac Surg 1993; 51(1 Suppl 1): 62-8.
  25. Robinson PP: Observations on the recovery of sensation following inferior alveolar nerve injuries. Br J Oral Maxillofac Surg 1988; 26(3): 177-89. https://doi.org/10.1016/0266-4356(88)90161-1
  26. Pogrel MA, Bryan J, Regezi J: Nerve damage associated with inferior alveolar nerve blocks. J Am Dent Assoc 1995; 126(8): 1150-5. https://doi.org/10.14219/jada.archive.1995.0336
  27. Pogrel MA: The results of microneurosurgery of the inferior alveolar and lingual nerve. J Oral Maxillofac Surg 2002; 60(5): 485-9. https://doi.org/10.1053/joms.2002.31841
  28. Pogrel MA, Schmidt BL, Sambajon V, Jordan RC: Lingual nerve damage due to inferior alveolar nerve blocks: a possible explanation. J Am Dent Assoc 2003; 134(2): 195-9. https://doi.org/10.14219/jada.archive.2003.0133
  29. Pogrel MA, Thamby S: Permanent nerve involvement resulting from inferior alveolar nerve blocks. J Am Dent Assoc 2000; 131(7): 901-7. https://doi.org/10.14219/jada.archive.2000.0308