Buchanan Glynn Dale, Smit Chane, Gamieldien Mohamed Yasin, ElSheshtawy Ahmed S
Faculty of Health Sciences, Department of Odontology, School of Dentistry, University of Pretoria, Pretoria, South Africa.
Faculty of Health Sciences, Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa.
J Endod. 2023 Jul;49(7):920-924. doi: 10.1016/j.joen.2023.05.004. Epub 2023 May 12.
Paresthesia is a potential consequence of unsuccessful root canal treatment. Persistent infection resulting in apical periodontitis may enlarge sufficiently to involve the mental neurovascular bundle. The case presented in this report was referred for endodontic evaluation with a chief complaint of discomfort on mastication and persistent numbness of the lower left lip. Clinical and radiographic evaluation revealed incomplete primary endodontic treatment of the left mandibular second premolar with complex internal anatomy. The untreated root canal system resulted in the progression of apical periodontitis involving the left mental neurovascular bundle as confirmed by cone-beam computed tomography imaging. Nonsurgical root canal retreatment was performed over 2 visits. At the 3-year follow-up visit, the paresthesia had resolved with return of normal sensation. Nonsurgical endodontic retreatment may be sufficient to allow healing of large periapical lesions and resolve complications including paresthesia without the need for surgical intervention.
感觉异常是根管治疗失败的一个潜在后果。导致根尖周炎的持续性感染可能会充分扩大，累及颏神经血管束。本报告中呈现的病例因咀嚼时不适和左下唇持续麻木的主要诉求而被转诊进行牙髓病学评估。临床和影像学评估显示，左下颌第二前磨牙的初次根管治疗不彻底，其内部解剖结构复杂。锥形束计算机断层扫描成像证实，未治疗的根管系统导致根尖周炎进展，累及左颏神经血管束。非手术根管再治疗分两次进行。在3年的随访中，感觉异常已消失，感觉恢复正常。非手术牙髓再治疗可能足以使大型根尖周病变愈合，并解决包括感觉异常在内的并发症，而无需手术干预。
