The extrusion of root canal cement containing paraformaldehyde into the inferior alveolar nerve canal resulting in infection and numbness

Abstract

A 30-year-old man was referred for management of prolonged anaesthesia in the right mandibular region following root canal treatment. Panoramic and cone beam computed tomography findings revealed that overextruded root canal cement had penetrated into the inferior alveolar nerve canal beyond the distal root of the mandibular right second molar (tooth 47). The root canal cement contained paraformaldehyde. Initially, the patient refused surgical removal of the cement. However, after 3.5 months, the patient returned with an acute infection in the same region. After resolution of the acute abscess and root canal retreatment, surgical treatment was performed under general anaesthesia. Granulation tissue and necrotic bone were found associated with the cement.

Correlation between Tooth Position Parameters and Apical Fenestration: A Cone-Beam Computed Tomography Study

“…These injuries range in severity from minor issues that are resolved spontaneously to more serious incidents necessitating surgical intervention. Examples include incidents such as sodium hypochlorite overflow, fractures of endodontic instruments, extrusion of debris and obturation cement, and occurrences of labio-mandibular paresthesia [33][34][35][36][37]. Additionally, the concept of apical foramen widening is discussed, allowing for increased chemical and mechanical intrusion in the periapical area during instrumentation.…”

Piezosurgical management of sealer extrusion‐associated mental nerve anaesthesia: A case report

“…Surgical treatment aims to decompress the nerve and remove the extruded materials. For decompressing a nerve bundle, bone removal is mandatory, either by removing the buccal cortical plate above the IAN or using a sagittal split technique . An alternative treatment is the removal of the tooth, extraoral management of the extruded material and then intentional tooth replantation .…”

Odontologia: uma visão contemporânea - Volume 15

“…Mesmo os materiais não neurotóxicos, como a guta-percha, podem causar danos irreversíveis se forem extruídos e entrarem em contato com algum nervo, pois induzem reação de corpo estranho e consequente compressão mecânica do nervo comprometido. No estado termoplástico a guta-percha causa, além de compressão do feixe neurovascular, lesão térmica direta (SCALA et al, 2014;TSESIS et al, 2014;ALONSO-EZPELETA et al, 2014;ESCODA-FRANCOLI et al, 2007;AHONEN et al, 2011;FANIBUNDA et al, 1998;COSKUNSES et al, 2017). Shin et al (2016) relataram um caso de parestesia ocasionada por extrusão de pastas a base de hidróxido de cálcio.…”