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Foreign body surgery in the inferior alveolar nerve canal following endodontic treatment Kristian K Blackhall Yee Khoo Ian P Downie Dental Update 2024 47:11, 707-709.
Authors
Kristian KBlackhall
Specialty Doctor in Oral and Maxillofacial Surgery, BDS, MFDS RCS Ed, Salisbury District Hospital
Endodontic treatment can result in the extrusion of dental sealant material beyond the apex of a tooth. Dental sealant materials are known to have potentially cytotoxic properties and can cause damage to biological structures. This article describes the case of a patient who had experienced a sustained painful dysaesthesia of the left inferior alveolar nerve as a result of extrusion of material beyond the apex of the tooth into the nerve canal, and the surgical approach taken to directly treat the nerve and improve her symptoms.
CPD/Clinical Relevance: Awareness of the potential and sustained effects of dental sealant material on biological tissue, as well as the proximity of important anatomical structures, such as the inferior alveolar nerve, will help practitioners in the safe treatment of patients. Additionally, an awareness of the signs and symptoms of foreign body reactions within soft tissues will aid diagnosis and prompt onward referral for specialist treatments.
Article
Root canal treatment is a commonly employed modality of treatment undertaken by dental practitioners to treat and preserve teeth that have lost vitality. Endodontic therapy involves the removal of the dental pulp, the subsequent shaping, cleaning, and irrigating of the root canals, and the obturation (filling) of the decontaminated canals. Filling of the cleaned and decontaminated canals is undertaken with an inert filling such as gutta-percha and sealed with the aid of a cement, typically eugenol-based.1
This material acts as a lubricant as it aids in the progression of the principal obturation material (core) during the compaction phase, allowing the material to be advanced to the required degree, and compressed and compacted to achieve a dense filling of the canal space. Furthermore, it also aids in the filling of the lateral and accessory canals, which would otherwise be impossible to fill with a single core of gutta-percha. These sealant materials usually bear antimicrobial properties,2 generally in the form of holding a prolonged alkaline pH,3 as well as its solubility into hard tissue structures.4,5 However, these properties can also result in damage to biological structures. Root canal cement can be extruded beyond the apex of a tooth during obturation.
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