Skip to main content

Advertisement

SpringerLink
Log in

Orthodontic-related nerve injuries: a review and case series

  • Clinical
  • Published:
British Dental Journal Submit manuscript

Abstract

Trigeminal neuropathy secondary to orthodontic tooth movement is reported as a rare occurrence. Risk assessment is possible to prevent or immediately treat these injuries and clinicians should be aware of the risk factors. Increasingly, orthodontics is provided by non-specialists and orthodontic therapists. This paper presents cases and a review of orthodontic-related nerve injuries, where early diagnosis of orthodontic nerve injuries was misdiagnosed, preventing early or immediate treatment that would have likely optimised neural recovery and prevented permanent sensory neuropathic pain in these patients. We present two cases of trigeminal neuropathy following orthodontic tooth movement that highlight some key issues relating to improving pre-orthodontic risk assessment during treatment planning and early identification of developing neuropathy requiring urgent cessation/reversal of orthodontic treatment. The cases presented demonstrate the importance of thorough pre-orthodontic assessment before treatment planning. Traditionally, two-dimensional imaging such as panoramic and periapical radiographs have been the gold standard for predicting the relationship of the dentition to the mandibular canal. However, cone beam computed tomography imaging is now accepted as providing a more accurate image of the position of the teeth in relation to vital structures, such as neurovascular supply.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig 1
Fig 2
Fig 3
Fig 4

Similar content being viewed by others

References

  1. American Association of Neurological Surgeons. Trigeminal Neuralgia. 2012. Available at https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Trigeminal-Neuralgia (accessed July 2020).

  2. Calverley J, Mohnac A M. Syndrome of the numb chin. Arch Intern Med 1963; 112: 819-821.

  3. Noordhoek R, Strauss R. Inferior Alveolar Nerve Paresthesia Secondary to Orthodontic Tooth Movement: Report of a Case. J Oral Maxillofac Surg 2010; 68: 1183-1185.

  4. Farronato G, Garagiola U, Farronato D, Bolzoni L, Parazzoli E. Temporary lip paresthesia during orthodonticmolar distalization: Report of a case. Am J Orthod Dentofac Orthop 2008; 133: 898-901.

  5. Mahmood H, Stern M, Atkins S. Inferior alveolar nerve anaesthesia: A rare complication of orthodontic tooth movement. J Orthod 2019; 46: 374-377.

  6. Diravidamani K, Sivalingam S, Agarwal V. Drugs influencing orthodontic tooth movement: An overall review. J Pharm BioAllied Sci 2012; 4: 299-303.

  7. Reitan K. Clinical and histological observation on tooth movement during and after orthodontic treatment. Am J Orthod 1967; 53: 721-745.

  8. Isaacson K, Thom A, Atack N, Horner K, Whaites E. Guidelines for the use of radiographs in clinical orthodontics. 2015. Available at https://www.bos.org.uk/Portals/0/Public/docs/General%20Guidance/Orthodontic%20Radiographs%202016%20-%202.pdf (accessed July 2020).

  9. Hujoel P, Hollender L, Bollen A, Young J, McGee M, Grosso A. Radiographs associated with one episode of orthodontic therapy. J Dent Educ 2006; 70: 1061-1065.

  10. Lorenzoni D, Bolognese A, Garib D, Guedes F, Sant'Anna E. Cone-beam computed tomography and radiographs in dentistry: aspects related to radiation dose. Int J Dent 2012; DOI: 10.1155/2012/813768.

  11. Colceriu-Şimon I, Băciuţ M, Ştiufiuc R et al. Clinical indications and radiation doses of cone beam computed tomography in orthodontics. Med Pharm Reports 2019; 92: 346-351.

  12. American Academy of Oral and Maxillofacial Radiology. Clinical recommendations regarding use of cone beam computed tomography in orthodontics. [corrected]. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116: 238-257.

  13. Turpin D. British Orthodontic Society revises guidelines for clinical radiography. Am J Orthod Dentofac Orthop 2008; 134: 597-598.

  14. SEDENTEXCT project. Radiation Protection No 172 - Cone Beam CT for Dental and Maxillofacial Radiology: Evidence-Based Guidelines. 2011. Available at http://www.sedentexct.eu/files/radiation_protection_172.pdf (accessed July 2020).

  15. Jacobs R, Bishara E, Jakobsen R. Profiling providers of orthodontic services in general dental practice. Am J Orthod Dentofac Orthop 1991; 99: 269-275.

  16. Agbaje J, de Casteele E, Hiel M, Verbaanderd C, Lambrichts I, Politis C. Neuropathy of trigeminal nerve branches after oral and maxillofacial treatment. J Oral Maxillofac Surg 2016; 15: 321-327.

  17. Politis C, Lambrichts I, Agbaje J O. Neuropathic pain after orthagnathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117: 102-107.

  18. Robinson P. Characteristics of patients referred to a UK trigeminal nerve injury service. Oral Surg 2011; 4: 8-14.

  19. Smith J, Elias L, Yilmaz Z et al. The psychosocial and affective burden of posttraumatic neuropathy following injuries to the trigeminal nerve. J Orofac Pain 2013; 27: 293-303.

  20. Tolle T, Dukes E, Sadosky A. Patient burden of trigeminal neuralgia: Results from a cross-sectional survey of health state impairment and treatment patterns in six European countries. Pain Pract 2006; 6: 153-160.

  21. Taïwe G, Kuete V. Management of inflammatory and nociceptive disorders in Africa. In Kuete V (ed) Medicinal Spices and Vegetables from Africa: Therapeutic Potential Against Metabolic, Inflammatory, Infectious and Systemic Diseases. pp 73-92. London: Elsevier, 2017.

  22. Ziccardi V, Assael L. Mechanisms of trigeminal nerve injuries. Atlas Oral Maxillofac Surg Clin North Am 2007; 9: 1-11.

  23. Coulthard P, Kushnerev E, Yates J et al. Interventions for iatrogenic inferior alveolar and lingual nerve injury. Cochrane Database Syst Rev 2014; DOI: 10.1002/14651858.CD005293.pub2.

  24. Renton T. Prevention of Iatrogenic Inferior Alveolar Nerve Injuries in Relation to Dental Procedures. Dent Update 2010; 37: 350-363.

  25. Umar G, Bryant C, Obisesan O, Rood J. Correlation of the radiological predictive factors of inferior alveolar nerve injury with cone beam computed tomography findings. Oral Surg 2010; 3: 72-82.

  26. Chana R, Wiltshire W, Cholakis A, Levine G. Use of cone-beam computed tomography in the diagnosis of sensory nerve paresthesia secondary to orthodontic tooth movement: A clinical report. Am J Orthod Dentofac Orthop 2013; 144: 299-303.

  27. Krogstad O, Omland G. Temporary paresthesia of the lower lip: a complication of orthodontic treatment. A case report. Br J Orthod 1997; 24: 13-15.

  28. Willy P J, Brennan P, Moore J. Temporary mental nerve paresthesia secondary to orthodontic treatment- a case report and review. Br Dent J 2004; 196: 83-84.

  29. Baxmann M. Mental Paresthesia and Orthodontic Treatment. Angle Orthod 2006; 76: 533-537.

  30. da Costa Monini A, Martins R P, Martins I P, Martins L P. Paresthesia during orthodontic treatment: case report and review. Quintessence Int 2011; 42: 761-769.

Download references

Author information

Authors and Affiliations

  1. Oral Surgery SPR, King’s College Dental Institute, Denmark Hill, Brixton, London, SE5 9RS, UK

    Sarah Jadun

  2. General Dental Practitioner, Douglas Miller Dental Practice, 2c Avenue Road, North Finchley, London, N12 8PY, UK

    Douglas Miller

  3. Professor, Oral Surgery, King’s College Dental Institute, Denmark Hill, Brixton, London, SE5 9RS, UK

    Tara Renton

Authors
  1. Sarah Jadun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Douglas Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tara Renton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah Jadun.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jadun, S., Miller, D. & Renton, T. Orthodontic-related nerve injuries: a review and case series. Br Dent J 229, 244–248 (2020). https://doi.org/10.1038/s41415-020-1994-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-020-1994-8

  • Springer Nature Limited

This article is cited by

Search

Navigation