National Maxillofacial Unit, St James´ Hospital, Dublin, Ireland.
Br Dent J. 2022 Oct;233(8):621-624. doi: 10.1038/s41415-022-5081-1. Epub 2022 Oct 28.
Introduction Needle fracture during the delivery of local anaesthesia is a rare complication in modern dentistry. While there has been a decline in its occurrence with the advent of disposable flexible alloys, it still occurs and it is important for all clinicians to know how to deal with this complication. The management of a lost needle in the pterygomandibular space when giving an inferior alveolar nerve block has proven a dilemma in the past. In this paper, we discuss how to minimise the risk and the relevant management of such a scenario while examining two cases of needle fracture while delivering an inferior alveolar nerve block.Discussion There are a number of structures present in the pterygomandibular space of which all clinicians should be cognisant. Should a needle fracture and cannot be removed immediately by the clinician, prompt maxillofacial referral is required for further management.Conclusion While rare, needle fracture can occur while delivering an inferior alveolar nerve block and all clinicians should be aware of how to minimise the risk and how to manage such a complication. If it cannot be removed at the time, a prompt maxillofacial referral should be made.
简介
在局部麻醉中发生的针断裂是现代牙科中罕见的并发症。尽管随着一次性柔性合金的出现，其发生率有所下降，但它仍然会发生，所有临床医生都必须知道如何处理这种并发症。在进行下牙槽神经阻滞时，翼下颌间隙中丢失的针的管理过去一直是一个难题。在本文中，我们讨论了如何在检查下牙槽神经阻滞时发生的两例针断裂的情况下，通过检查两个病例来最小化这种情况的风险和相关管理。
讨论
翼下颌间隙中有许多结构，所有临床医生都应该意识到。如果针断裂且不能立即由临床医生取出，则需要立即进行颌面转科以进行进一步管理。
结论
虽然罕见，但在进行下牙槽神经阻滞时可能会发生针断裂，所有临床医生都应了解如何最小化风险以及如何处理这种并发症。如果当时无法取出，则应立即进行颌面转科。
