Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report
신유석, 노병덕, 김예미, 김태현, 김형준,
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신유석 ( Shin Yoo-Seok ) - Yonsei University College of Dentistry Department of Conservative Dentistry
노병덕 ( Roh Byoung-Duck ) - Yonsei University College of Dentistry Department of Conservative Dentistry
김예미 ( Kim Ye-Mi ) - Ewha Womans University Department of Conservative Dentistry
김태현 ( Kim Tae-Hyeon ) - Yonsei University College of Dentistry Department of Prosthodontics
김형준 ( Kim Hyung-Jun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1034420160410010063
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.
키워드
Calcium hydroxide; Extrusion; Inferior alveolar nerve; Neurotoxic effects; Surgical debridement
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