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KMID : 0355220110360030199
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Journal of Korean Academy Oral Medicine
2011 Volume.36 No. 3 p.199 ~ p.205
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Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment
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Bae Kook-Jin
Ahn Jong-Mo
Yoon Chang-Lyuk
Cho Young-Gon
Ryu Ji-Won
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Abstract
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During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia.
Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause.
However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain.
This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient’s condition with clinical neurosensory examination and current perception threshold test(Neurometer).
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KEYWORD
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Current perception threshold, Endodontic complication, Endodontic sealer, Gabapentin, Inferior alveolar nerve injuries
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