Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?

The mandibular premolars are located close to the mental foramina (Fig. 1). As such, various events affecting these teeth, such as odontogenic infection1 and orthodontic, endodontic, periodontal or surgical misadventure, may result in neurosensory disturbance of the mental nerves.2-4 In one retrospe...

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Main Author: Ngeow, Wei Cheong
Format: Article
Language:English
Published: Canadian Dental Association 2010
Subjects:
Online Access:http://eprints.um.edu.my/2879/1/Is_there_a_safety_zon_in_the_mandibular_premolar_region_where_damage_to_the_mental_nerve_can_be_avoided_if_periapical_extrusion_occurs.pdf
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author Ngeow, Wei Cheong
author_facet Ngeow, Wei Cheong
author_sort Ngeow, Wei Cheong
collection UM
description The mandibular premolars are located close to the mental foramina (Fig. 1). As such, various events affecting these teeth, such as odontogenic infection1 and orthodontic, endodontic, periodontal or surgical misadventure, may result in neurosensory disturbance of the mental nerves.2-4 In one retrospective study, the incidence of mental paresthesia resulting from periapical infection or pathology was 0.96. In another 0.24 of cases in the same study, mental paresthesia was a complication of root canal treatment (caused by severe overfill in one case and iatrogenic perforation of mechanical instrumentation through the root and into the mental nerve in the second case).1 The incidence of mental paresthesia resulting from orthodontic, periodontal and surgical misadventure cannot be determined but is presumably low, as most such cases have been reported as individual case reports. In endodontology, elimination of infection from the pulp and dentin followed by adequate intracanal preparation and proper sealing constitute the basic principles of root canal treatment. Ideally, mechanical preparation and filling should be limited to the root canal, as overinstrumentation or extrusion of chemical fillings beyond the apical foramen to the adjacent nerve may give rise to neurosensory disturbances such as anesthesia, paresthesia or dysesthesia.5 Unfortunately, cases of endodontic extrusion of various filling or irrigation agents continue to be reported, despite recent advances in endodontology.
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spelling um.eprints-28792019-11-13T06:51:18Z http://eprints.um.edu.my/2879/ Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs? Ngeow, Wei Cheong R Medicine RK Dentistry The mandibular premolars are located close to the mental foramina (Fig. 1). As such, various events affecting these teeth, such as odontogenic infection1 and orthodontic, endodontic, periodontal or surgical misadventure, may result in neurosensory disturbance of the mental nerves.2-4 In one retrospective study, the incidence of mental paresthesia resulting from periapical infection or pathology was 0.96. In another 0.24 of cases in the same study, mental paresthesia was a complication of root canal treatment (caused by severe overfill in one case and iatrogenic perforation of mechanical instrumentation through the root and into the mental nerve in the second case).1 The incidence of mental paresthesia resulting from orthodontic, periodontal and surgical misadventure cannot be determined but is presumably low, as most such cases have been reported as individual case reports. In endodontology, elimination of infection from the pulp and dentin followed by adequate intracanal preparation and proper sealing constitute the basic principles of root canal treatment. Ideally, mechanical preparation and filling should be limited to the root canal, as overinstrumentation or extrusion of chemical fillings beyond the apical foramen to the adjacent nerve may give rise to neurosensory disturbances such as anesthesia, paresthesia or dysesthesia.5 Unfortunately, cases of endodontic extrusion of various filling or irrigation agents continue to be reported, despite recent advances in endodontology. Canadian Dental Association 2010-06-16 Article PeerReviewed application/pdf en http://eprints.um.edu.my/2879/1/Is_there_a_safety_zon_in_the_mandibular_premolar_region_where_damage_to_the_mental_nerve_can_be_avoided_if_periapical_extrusion_occurs.pdf Ngeow, Wei Cheong (2010) Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs? Journal of the Canadian Dental Association, 76. a61. ISSN 1488-2159, https://jcda.ca/article/a61
spellingShingle R Medicine
RK Dentistry
Ngeow, Wei Cheong
Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title_full Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title_fullStr Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title_full_unstemmed Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title_short Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?
title_sort is there a safety zone in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs
topic R Medicine
RK Dentistry
url http://eprints.um.edu.my/2879/1/Is_there_a_safety_zon_in_the_mandibular_premolar_region_where_damage_to_the_mental_nerve_can_be_avoided_if_periapical_extrusion_occurs.pdf
work_keys_str_mv AT ngeowweicheong isthereasafetyzoneinthemandibularpremolarregionwheredamagetothementalnervecanbeavoidedifperiapicalextrusionoccurs