Li Bo, Wang Lunchang, Zhao Zhihe, Qian Hongbo, Cui Han, Li Longjiang
*State Key Laboratory of Oral Diseases, Sichuan University †West China Hospital of Stomatology, Sichuan University, Chengdu ‡Guangyuan Central Hospital, Guangyuan, China.
J Craniofac Surg. 2017 Sep;28(6):1514-1516. doi: 10.1097/SCS.0000000000003521.
This clinical report describes a relatively infrequent patient with inferior alveolar nerve damage caused by foreign material within the mandibular canal, which is one of the most severe complications of endodontic therapy. Although the circumstance is uncommon, it can have extremely unfavorable consequences for patients, such as anesthesia and paresthesia. In the present case, a patient suffered pain and severe paresthesia in the corresponding area after routine endodontic therapy. Several treatments were conducted to relieve the patient's symptoms, ranging from medication to tooth extraction, but all were of no avail. Ultimately, surgical exploration and debridement were performed with assistance of a customized surgical template. Once the foreign material was excavated, the exacerbation of condition was terminated and gradually reverted. This patient illustrates that special attention is required when undertaking intracanal procedures of lower posterior teeth so as to avoid iatrogenic damage to inferior alveolar nerve. Even more significant, when above-mentioned condition occurs, prompt surgical intervention is essential for recovery of sensation. It also demonstrates the advantages of applying surgical template and piezosurgery in removal of foreign material within the mandibular canal.
本临床报告描述了一名相对罕见的患者，其下颌管内的异物导致下牙槽神经损伤，这是牙髓治疗最严重的并发症之一。尽管这种情况并不常见，但它可能给患者带来极其不利的后果，如麻醉和感觉异常。在本病例中，一名患者在常规牙髓治疗后，相应区域出现疼痛和严重的感觉异常。为缓解患者症状进行了多种治疗，从药物治疗到拔牙，但均无效果。最终，在定制手术模板的辅助下进行了手术探查和清创。一旦挖出异物，病情恶化即告终止，并逐渐好转。该患者表明，在下颌后牙进行根管内操作时需要特别注意，以避免医源性损伤下牙槽神经。更重要的是，当出现上述情况时，及时的手术干预对于感觉恢复至关重要。它还展示了应用手术模板和超声骨刀在清除下颌管内异物方面的优势。
