Shin Yooseok, Roh Byoung-Duck, Kim Yemi, Kim Taehyeon, Kim Hyungjun
Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
Department of Conservative Dentistry, Ewha Womans University, Seoul, Korea.
Restor Dent Endod. 2016 Feb;41(1):63-7. doi: 10.5395/rde.2016.41.1.63. Epub 2016 Jan 6.
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.
在临床牙髓治疗过程中，我们经常会发现根尖孔外有不透射线的充填材料。氢氧化钙意外挤出可能会导致下牙槽神经损伤，如感觉异常或持续的炎症反应。本病例报告介绍了氢氧化钙的挤出情况以及包括手术干预在内的治疗过程。一名48岁女性患者在牙髓治疗期间，Calcipex II被挤出至左下颌区域的下牙槽管内。在完成左下颌第一磨牙的牙髓治疗后，计划在全身麻醉下进行手术干预。在进行皮质骨截骨术和清创后，进行了神经瘤切除和神经缝合，并观察了预后情况。但在手术干预20个月后，感觉神经未见改善。临床医生应注意根管内药物的挤出以及下牙槽管受损的可能性。应谨慎使用可注射型氢氧化钙以防止神经损伤。建议在下颌后磨牙使用诸如慢锥钻等替代给药方法。
