Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

  • Shin, Yooseok (Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Roh, Byoung-Duck (Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Kim, Yemi (Department of Conservative Dentistry, Ewha Womans University) ;
  • Kim, Taehyeon (Department of Prosthodontics, College of Dentistry, Yonsei University) ;
  • Kim, Hyungjun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • Received : 2015.04.10
  • Accepted : 2015.11.24
  • Published : 2016.02.29
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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.

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References

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  3. Massive extrusion of calcium hydroxide paste containing barium sulphate during endodontic treatment vol.46, pp.2, 2020, https://doi.org/10.1111/aej.12382
  4. Microsurgical Repair of Inferior Alveolar Nerve Injuries Associated With Endodontic Treatment: Results on Sensory Function and Relief of Pain vol.79, pp.7, 2016, https://doi.org/10.1016/j.joms.2021.01.037