Altered sensation following extrusion of an endodontic file treated by intentional replantation: case report and treatment recommendations.

IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Fares Kablan, Abdallah Fahoum, Daniel Moreinos, Samer Srouji, Iris Slutzky-Goldberg
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引用次数: 0

Abstract

Objective: An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address paresthesia resulting from an endodontic file penetrating the inferior alveolar nerve canal and provide a protocol for managing nerve injuries in such incidents.

Case presentation: A 12-year-old girl developed paresthesia when an endodontic file separated and was inadvertently pushed through the apical foramen into the inferior alveolar nerve canal during root canal treatment of the mandibular left first molar. A CBCT scan revealed the file penetrating the canal towards the inferior border of the mandible. After considering the treatment options, intentional replantation was deemed suitable. The tooth was atraumatically extracted and preserved in sterile saline. The surgeon then carefully cleaned and irrigated the socket. The radiographic assessment confirmed successful file removal from the socket. The root ends were resected, and retrograde preparation and obturation were conducted using ultrasonic tips and mineral trioxide aggregate. The tooth was then replanted into the socket. Successful replantation was confirmed by tooth stability and an audible click. The patient was prescribed antibiotics and steroids. After completion of the endodontic treatment, a stainless steel crown was cemented. The successful intentional replantation procedure resulted in rapid improvement in the patient's condition. The normal sensation had been restored, indicating nerve recovery. At the 15-month follow-up, periapical bone healing and the eruption of the adjacent second molar were observed, affirming the treatment protocol's overall success.

Conclusion: Prompt intervention and immediate intentional replantation facilitated direct inspection of the separated file within the socket. Collaboration between an oral maxillofacial surgeon and an endodontist ensures expedited and targeted treatment, leading to favorable outcomes.

通过有意再植法治疗牙髓锉挤出后的感觉改变:病例报告和治疗建议。
目的:在牙髓治疗过程中,由于牙髓材料的挤压可能会导致感觉改变。本研究旨在讨论有意重新种植以解决牙髓锉穿透下牙槽神经管(IANC)导致的麻痹,并提供在此类事件中处理神经损伤的方案:一名 12 岁女孩在下颌左侧第一磨牙的根管治疗过程中,牙髓锉分离并不慎通过根尖孔推入下牙槽神经管(IANC),导致其出现麻痹症状。CBCT 扫描显示,锉刀穿透根管到达下颌骨下缘。在考虑了各种治疗方案后,认为有意再植是合适的。经气道将牙齿拔出,并保存在无菌生理盐水中。然后,外科医生仔细地清洁和冲洗了牙槽。影像学评估证实,锉刀已成功从牙槽骨中取出。切除牙根末端,使用超声波探头和 MTA 进行逆行预备和封闭。然后将牙齿重新植入牙槽窝。通过牙齿的稳定性和咔哒声确认重新镶牙成功。患者接受了抗生素和类固醇治疗。随后,在完成牙髓治疗后,粘接了不锈钢牙冠。成功的有意再植手术使患者的病情迅速好转。正常的感觉已经恢复,表明神经已经恢复。在 15 个月的随访中,观察到根尖周骨质愈合,相邻的第二颗臼齿也已萌出,证明治疗方案总体上是成功的:结论:及时干预并立即有意识地重新种植有助于直接检查牙槽窝内分离的锉刀。口腔颌面外科医生和牙髓病学家之间的合作确保了治疗的快速性和针对性,从而取得了良好的治疗效果。
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来源期刊
Quintessence international
Quintessence international 医学-牙科与口腔外科
CiteScore
3.30
自引率
5.30%
发文量
11
审稿时长
1 months
期刊介绍: QI has a new contemporary design but continues its time-honored tradition of serving the needs of the general practitioner with clinically relevant articles that are scientifically based. Dr Eli Eliav and his editorial board are dedicated to practitioners worldwide through the presentation of high-level research, useful clinical procedures, and educational short case reports and clinical notes. Rigorous but timely manuscript review is the first order of business in their quest to publish a high-quality selection of articles in the multiple specialties and disciplines that encompass dentistry.
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