Abstract
Nerve injuries with altered sensations following endodontic surgical procedures represent a rare but serious complication, and the classification of those injuries is based on their time course and on the potential sensory recovery following the injury.
Direct trauma to the nerve bundle during surgery is the most frequent cause of nerve injury and may lead to long-term disability and to significant negative effects on the patient’s quality of life.
Active preventive measures and a timely mannered clinical approach when a nerve injury is suspected are the most efficient measures to minimize the risk for nerve injuries during surgical procedures as well as to prevent permanent damage and enable better clinical and medicolegal outcomes when such injuries do occur.
This chapter is aimed to provide the practitioner with both knowledge and practical tools to prevent and to manage a nerve injury when performing endodontic surgical procedures, thus to enable a safer procedure and a more predictable clinical outcome.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Escoda-Francoli J, Canalda-Sahli C, Soler A, Figueiredo R, Gay-Escoda C. Inferior alveolar nerve damage because of overextended endodontic material: a problem of sealer cement biocompatibility? J Endod. 2007;33(12):1484–9.
Grotz KA, Al-Nawas B, de Aguiar EG, Schulz A, Wagner W. Treatment of injuries to the inferior alveolar nerve after endodontic procedures. Clin Oral Investig. 1998;2(2):73–6.
Yatsuhashi T, Nakagawa K, Matsumoto M, Kasahara M, Igarashi T, Ichinohe T, et al. Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment. Bull Tokyo Dent Coll. 2003;44(4):209–12.
Gallas-Torreira MM, Reboiras-Lopez MD, Garcia-Garcia A, Gandara-Rey J. Mandibular nerve paresthesia caused by endodontic treatment. Med Oral. 2003;8(4):299–303.
Givol N, Rosen E, Bjorndal L, Taschieri S, Ofec R, Tsesis I. Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(1):126–31.
Pogrel MA. Damage to the inferior alveolar nerve as the result of root canal therapy. J Am Dent Assoc. 2007;138(1):65–9.
Tilotta-Yasukawa F, Millot S, El Haddioui A, Bravetti P, Gaudy JF. Labiomandibular paresthesia caused by endodontic treatment: an anatomic and clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(4):e47–59.
Garisto GA, Gaffen AS, Lawrence HP, Tenenbaum HC, Haas DA. Occurrence of paresthesia after dental local anesthetic administration in the United States. J Am Dent Assoc. 2010;141(7):836–44.
Bornstein MM, Lauber R, Sendi P, von Arx T. Comparison of periapical radiography and limited cone-beam computed tomography in mandibular molars for analysis of anatomical landmarks before apical surgery. J Endod. 2011;37(2):151–7.
Kamburoglu K, Kilic C, Ozen T, Yuksel SP. Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(2):e34–42.
Kim TS, Caruso JM, Christensen H, Torabinejad M. A comparison of cone-beam computed tomography and direct measurement in the examination of the mandibular canal and adjacent structures. J Endod. 2010;36(7):1191–4.
Kovisto T, Ahmad M, Bowles WR. Proximity of the mandibular canal to the tooth apex. J Endod. 2011;37(3):311–5.
Simonton JD, Azevedo B, Schindler WG, Hargreaves KM. Age- and gender-related differences in the position of the inferior alveolar nerve by using cone beam computed tomography. J Endod. 2009;35(7):944–9.
Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod. 2006;32(7): 601–23.
Moiseiwitsch JR. Avoiding the mental foramen during periapical surgery. J Endod. 1995;21(6):340–2.
Juodzbalys G, Wang H, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. 2011;2(1):e1.
Seddon HJ. A classification of nerve injuries. Br Med J. 1942;2(4260):237–9.
Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg. 2006;35(5):437–43.
Misch K, Wang HL. Implant surgery complications: etiology and treatment. Implant Dent. 2008;17(2):159–68.
Park SH, Wang HL. Implant reversible complications: classification and treatments. Implant Dent. 2005;14(3):211–20.
Annibali S, Ripari M, La Monaca G, Tonoli F, Cristalli MP. Local accidents in dental implant surgery: prevention and treatment. Int J Periodontics Restorative Dent. 2009;29(3):325–31.
Bjorndal L, Reit C. Endodontic malpractice claims in Denmark 1995–2004. Int Endod J. 2008;41(12):1059–65.
Chaushu G, Taicher S, Halamish-Shani T, Givol N. Medicolegal aspects of altered sensation following implant placement in the mandible. Int J Oral Maxillofac Implants. 2002;17(3):413–5.
Givol N, Rosen E, Taicher S, Tsesis I. Risk management in endodontics. J Endod. 2010;36(6):982–4.
Givol N, Taicher S, Halamish-Shani T, Chaushu G. Risk management aspects of implant dentistry. Int J Oral Maxillofac Implants. 2002;17(2):258–62.
Patel S. New dimensions in endodontic imaging: part 2. Cone beam computed tomography. Int Endod J. 2009;42(6):463–75.
American Association of Endodontics, American Academy of Oral and Maxillofacial Radiology. AAE and AAOMR joint position statement – use of cone-beam-computed tomography in endodontics. Chicago. 2010.
de Paula-Silva FW, Wu MK, Leonardo MR, da Silva LA, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod. 2009;35(7):1009–12.
Pinsky HM, Dyda S, Pinsky RW, Misch KA, Sarment DP. Accuracy of three-dimensional measurements using cone-beam CT. Dentomaxillofac Radiol. 2006;35(6):410–6.
Manski RJ, Moeller JF, Maas WR. Dental services. An analysis of utilization over 20 years. J Am Dent Assoc. 2001;132(5):655–64.
Wallace JA. Transantral endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(1):80–3.
Concepcion M, Rankow HJ. Accessory branch of the mental nerve. J Endod. 2000;26(10):619–20.
Katakami K, Mishima A, Shiozaki K, Shimoda S, Hamada Y, Kobayashi K. Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images. J Endod. 2008;34(12): 1441–5.
Czarnowski C, Ponka D, Rughani R, Geoffrion P. See one. Do one. Teach one: office-based minor surgical procedures. Can Fam Physician. 2008;54(6):893.
Miller MD. Office procedures. Education, training, and proficiency of procedural skills. Prim Care. 1997;24(2):231–40.
Wesson CM, Gale TM. Molar apicectomy with amalgam root-end filling: results of a prospective study in two district general hospitals. Br Dent J. 2003;195(12):707–14; discussion 698.
Bahcall JK. Visual enhancement. In: Ingle JI, Bakland LK, Baumgartner JC, editors. Ingle’s endodontics. Hamilton: BC Decker Inc; 2008. p. 870–6.
Del Fabbro M, Taschieri S. Endodontic therapy using magnification devices: a systematic review. J Dent. 2010;38(4):269–75.
Del Fabbro M, Taschieri S, Lodi G, Banfi G, Weinstein RL. Magnification devices for endodontic therapy. Cochrane Database Syst Rev. 2009;(3):CD005969.
Taschieri S, Del Fabbro M, Weinstein T, Rosen E, Tsesis I. Magnification in modern endodontic practice. Refuat Hapeh Vehashinayim. 2010;27(3):18–22, 61.
Baldassari-Cruz LA, Lilly JP, Rivera EM. The influence of dental operating microscope in locating the mesiolingual canal orifice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(2):190–4.
de Carvalho MC, Zuolo ML. Orifice locating with a microscope. J Endod. 2000;26(9):532–4.
Gorduysus MO, Gorduysus M, Friedman S. Operating microscope improves negotiation of second mesiobuccal canals in maxillary molars. J Endod. 2001;27(11):683–6.
Slaton CC, Loushine RJ, Weller RN, Parker MH, Kimbrough WF, Pashley DH. Identification of resected root-end dentinal cracks: a comparative study of visual magnification. J Endod. 2003;29(8):519–22.
Zaugg B, Stassinakis A, Hotz P. Influence of magnification tools on the recognition of simulated preparation and filling errors. Schweiz Monatsschr Zahnmed. 2004;114(9):890–6.
Froes FG, Miranda AM, Abad Eda C, Riche FN, Pires FR. Non-surgical management of paraesthesia and pain associated with endodontic sealer extrusion into the mandibular canal. Aust Endod J. 2009;35(3):183–6.
Han SR, Yeo SP, Lee MK, Bae YC, Ahn DK. Early dexamethasone relieves trigeminal neuropathic pain. J Dent Res. 2010;89(9):915–20.
Seo K, Tanaka Y, Terumitsu M, Someya G. Efficacy of steroid treatment for sensory impairment after orthognathic surgery. J Oral Maxillofac Surg. 2004;62(10):1193–7.
Scolozzi P, Lombardi T, Jaques B. Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(5):625–31.
Seddon HJ, Medawar PB, Smith H. Rate of regeneration of peripheral nerves in man. J Physiol. 1943;102(2):191–215.
Campbell RL, Parks KW, Dodds RN. Chronic facial pain associated with endodontic therapy. Oral Surg Oral Med Oral Pathol. 1990;69(3):287–90.
Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L, et al. EFNS guidelines on neuropathic pain assessment: revised 2009. Eur J Neurol. 2010;17(8):1010–8.
Fagade OO, Wastell DG. Trigeminal somatosensory evoked potentials: technical parameters, reliability and potential in clinical dentistry. J Dent. 1990;18(3):137–41.
Meyer RA, Bagheri SC. Clinical evaluation of peripheral trigeminal nerve injuries. Atlas Oral Maxillofac Surg Clin North Am. 2011;19(1):15–33.
Polycarpou N, Ng YL, Canavan D, Moles DR, Gulabivala K. Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing. Int Endod J. 2005;38(3):169–78.
Poort LJ, van Neck JW, van der Wal KG. Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies. J Oral Maxillofac Surg. 2009;67(2):292–300.
Bennett AJ, Wastell DG, Barker GR, Blackburn CW, Rood JP. Trigeminal somatosensory evoked potentials. A review of the literature as applicable to oral dysaesthesias. Int J Oral Maxillofac Surg. 1987;16(4): 408–15.
Bennett MH, Jannetta PJ. Trigeminal evoked potentials in humans. Electroencephalogr Clin Neurophysiol. 1980;48(5):517–26.
Ghali GE, Epker BN. Clinical neurosensory testing: practical applications. J Oral Maxillofac Surg. 1989;47(10):1074–8.
Barker GR, Bennett AJ, Wastell DG. Applications of trigeminal somatosensory evoked potentials (TSEPs) in oral and maxillofacial surgery. Br J Oral Maxillofac Surg. 1987;25(4):308–13.
Pogrel MA, Jergensen R, Burgon E, Hulme D. Long-term outcome of trigeminal nerve injuries related to dental treatment. J Oral Maxillofac Surg. 2011;69(9):2284–8.
Graff-Radford SB, Evans RW. Lingual nerve injury. Headache. 2003;43(9):975–83.
Osunde OD, Adebola RA, Omeje UK. Management of inflammatory complications in third molar surgery: a review of the literature. Afr Health Sci. 2011;11(3): 530–7.
Cotter DJ. Overview of transcutaneous electrical nerve stimulation for treatment of acute postoperative pain. Med Instrum. 1983;17(4):289–92.
Singla S, Prabhakar V, Singla RK. Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia. J Neurosci Rural Pract. 2011;2(2):150–2.
Leung YY, Fung PP, Cheung LK. Treatment modalities of neurosensory deficit after lower third molar surgery: a systematic review. J Oral Maxillofac Surg. 2012;70(4):768–78.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Rosen, E. (2014). Nerve Injury During Endodontic Surgical Procedures. In: Tsesis, I. (eds) Complications in Endodontic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54218-3_13
Download citation
DOI: https://doi.org/10.1007/978-3-642-54218-3_13
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-54217-6
Online ISBN: 978-3-642-54218-3
eBook Packages: MedicineMedicine (R0)