School of Dentistry, Sapienza University of Rome, Rome, Italy.
Int Endod J. 2011 Feb;44(2):176-81. doi: 10.1111/j.1365-2591.2010.01816.x. Epub 2010 Nov 17.
To discuss the use of cone-beam computed tomography (CBCT) in the differential diagnosis of a case of labiomandibular paraesthesia caused by extrusion of endodontic sealer into the mandibular canal.
A 59-year-old woman suffering from a paraesthesia on the left posterior mandible and numbness on the left side of the lower lip was referred to an endodontic specialist 1 month after multiple root canal treatments. A panoramic radiograph revealed the presence of extruded root filling material beyond the apex of the mesial root of the mandibular left second molar and also beyond the apex of the first premolar. A cone beam computed tomography examination was undertaken, which confirmed the presence of radiopaque root canal filling material in the periapical area of the second molar, and revealed that the material was inside the mandibular canal. No extruded filling material was found inside the mental foramen beyond the apex of the first premolar tooth.
Small field of view CBCT (where possible) can be considered an effective radiographic diagnostic device when endodontic-related inferior alveolar nerve or mental foramen paraesthesia are suspected. CBCT is able to provide detailed three-dimensional images of the tooth, the root canal system and the surrounding tissue.
讨论使用锥形束 CT（CBCT）对根管封闭剂挤出到下颌管引起的下颌唇颏部感觉异常进行鉴别诊断的应用。
一名 59 岁女性在多次根管治疗后 1 个月，出现左侧下颌后牙区感觉异常和左侧下唇麻木，被转诊至牙髓专科医生处。全景片显示下颌左侧第二磨牙近中根根尖以外和第一前磨牙根尖以外有挤出的根充材料。进行锥形束 CT 检查，证实第二磨牙根尖周区域有不透射线的根管充填材料，并且显示材料位于下颌管内。在第一前磨牙根尖以外的颏孔内未发现挤出的充填材料。
当怀疑与根管相关的下牙槽神经或颏孔感觉异常时，小视野锥形束 CT（如有可能）可被视为有效的放射诊断设备。CBCT 能够提供牙齿、根管系统和周围组织的详细三维图像。
