Gallas-Torreira M Mercedes, Reboiras-López M Dolores, García-García Abel, Gándara-Rey José
Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Spain.
Med Oral. 2003 Aug-Oct;8(4):299-303.
The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described.
下牙槽神经感觉异常是一种并发症，可发生于各种牙科手术后，如囊肿切除术、阻生牙拔除术、根尖切除术、牙髓治疗、局部麻醉剂注射、义齿修复前或种植手术。神经损伤的可能机制包括机械性、化学性和热性。机械性损伤包括压迫、拉伸、部分或完全切除以及撕裂。这种损伤可导致神经连续性中断，伴有远端和覆盖层整合纤维的华勒变性（轴突断裂），或可导致神经完全横断（神经断裂）。化学性创伤可能归因于牙髓充填材料（多聚甲醛、皮质类固醇或丁香酚）、冲洗液（次氯酸钠）或局部麻醉剂中的某些有毒成分。热性损伤是手术操作过程中骨过热的结果。我们报告了一例在下颌第一磨牙根管治疗过程中，将牙胶尖插入下颌管后发生下牙槽神经感觉异常的临床病例。本文描述了这种牙髓并发症的病因及治疗方法。
