Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University Graz, Billrothgasse 4, 8010, Graz, Austria.
Office for Maxillofacial Surgery and Dental Medicine, Ringweg 98530, 8530, Deutschlandsberg, Austria.
Clin Oral Investig. 2019 Mar;23(3):1109-1119. doi: 10.1007/s00784-018-2525-8. Epub 2018 Jun 29.
The aim of this publication is to provide a concept for prevention and a standardized step-by-step clinical approach to this rare but serious and potentially preventable complication of dental local anesthesia.
We collected data with a PUBMED search using the key words "local anesthesia," "dental anesthesia/anesthesia" OR "mandibular block anesthesia," "complication," "hypodermic needle," "needle breakage" OR "needle fracture," and "foreign body AND removal" OR "retrieval." The existing literature was systematically evaluated from 1980 to date using Microsoft Excel 2007 (Microsoft Corporation).
After analysis of the literature, we included 36 reports documenting 59 needle breakage events and defined possible risk factors and preventive measures. All relevant reported parameters were listed in tabular form. The main result of this article is a treatment algorithm for this complication.
Prevention of a needle fracture should be the main goal during local dental anesthesia. Use of longer hypodermic needle can obviate complex retrieval surgery. If immediate removal of the fragment fails, localization, planning, and the necessary surgical procedure should be arranged promptly.
Following a strict algorithm, successful surgical handling of this complication will depend on minimizing risk and following treatment recommendations closely.
本出版物旨在提供一种预防概念和标准化的临床处理步骤，以应对这种罕见但严重且潜在可预防的牙科局部麻醉并发症。
我们使用 PUBMED 搜索，使用关键词“局部麻醉”、“牙科麻醉/麻醉”或“下颌阻滞麻醉”、“并发症”、“皮下注射针”、“针断裂”或“针折断”和“异物和取出”或“检索”收集数据。使用 Microsoft Excel 2007（微软公司）系统地评估了从 1980 年至今的现有文献。
对文献进行分析后，我们纳入了 36 份报告，记录了 59 次针断裂事件，并确定了可能的危险因素和预防措施。所有相关报告的参数均以表格形式列出。本文的主要结果是该并发症的治疗算法。
预防针折断应是局部牙科麻醉的主要目标。使用较长的皮下注射针可以避免复杂的检索手术。如果立即取出碎片失败，应迅速定位、规划并安排必要的手术程序。
严格遵循算法，成功处理这种并发症将取决于最大限度地降低风险和密切遵循治疗建议。
