国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (3): 293-296.doi: 10.7518/gjkq.2020063

• 病例报告 • 上一篇    下一篇

根管超填导致下牙槽神经损伤2例

唐蓓,赵文俊,王虎,郑广宁,游梦()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心四川大学华西口腔医院口腔放射科 成都 610041
  • 收稿日期:2019-05-25 修回日期:2019-08-23 出版日期:2020-05-01 发布日期:2020-05-08
  • 通讯作者: 游梦
  • 作者简介:唐蓓,讲师,博士,Email：48058577@qq.com
  • 基金资助:
    四川省应用基础研究计划(2010jy0056)

Inferior alveolar nerve injury due to apical overfilling: two cases reports

Tang Bei,Zhao Wenjun,Wang Hu,Zheng Guangning,You Meng()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-05-25 Revised:2019-08-23 Online:2020-05-01 Published:2020-05-08
  • Contact: Meng You
  • Supported by:
    Applied Basic Research Programs of Sichuan Province(2010jy0056)

RichHTML

66

PDF (PC)

719

摘要：

口腔有创操作有导致下牙槽神经损伤的风险,根管治疗术导致下牙槽神经损伤的情况虽然较为罕见,但一旦出现会造成较严重的神经症状。本文报道下颌磨牙根管治疗术后因根管充填材料进入下颌管并引发下牙槽神经相关症状病例2例,并结合文献探讨其临床及X线影像学表现,提出预防及治疗措施,为临床此类风险的规避提供参考。

关键词: 根管治疗, 并发症, 下颌管, 神经损伤, 锥形束CT

Abstract:

Invasive oral cavity treatment is associated with the risk of inferior alveolar nerve injury. Root canal therapy as the root cause of this injury is rare but may lead to severe neurologic complications. This report presents two patients who complained of neurologic complication after overextension of canal filling material during endodontic treatment. Clinical manifestations, X-ray imaging, and prevention and treatment measures were discussed with the aid of available literature to provide references for avoiding such risks in clinic.

Key words: root canal therapy, complication, mandibular canal, never injury, cone beam computed tomography

中图分类号: 

  • R781.05

图 1

病例1术前影像学检查 A：根尖片;B：CBCT片。白色箭头：根管超填物。"

图 2

病例2术前曲面断层片 黑色箭头：左下颌管区域。"

图 3

病例2术前CBCT影像 黑色箭头：根管超填物；白色箭头：下颌孔。"

图 4

病例2术后半年曲面断层片"

[1] Kim JE, Cho JB, Yi WJ , et al. Accidental overex-tension of endodontic filling material in patients with neurologic complications: a retrospective case series[J]. Dentomaxillofac Radiol, 2016,45(5):20150394.
doi: 10.1259/dmfr.20150394 pmid: 26915406
[2] Scolozzi P, Lombardi T, Jaques B . Successful in-ferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004,97(5):625-631.
doi: 10.1016/S1079210404000502 pmid: 15153877
[3] López-López J, Estrugo-Devesa A, Jané-Salas E , et al. Inferior alveolar nerve injury resulting from ove-rextension of an endodontic sealer: non-surgical management using the GABA analogue pregabalin[J]. Int Endod J, 2012,45(1):98-104.
doi: 10.1111/j.1365-2591.2011.01939.x pmid: 21883296
[4] Gatot A, Peist M, Mozes M . Endodontic overextension produced by injected thermoplasticized gutta-percha[J]. J Endod, 1989,15(6):273-274.
doi: 10.1016/S0099-2399(89)80223-7 pmid: 2592884
[5] Neaverth EJ . Disabling complications following inadvertent overextension of a root canal filling ma-terial[J]. J Endod, 1989,15(3):135-139.
doi: 10.1016/S0099-2399(89)80136-0 pmid: 2607283
[6] Pogrel MA . Damage to the inferior alveolar nerve as the result of root canal therapy[J]. J Am Dent Assoc, 2007,138(1):65-69.
doi: 10.14219/jada.archive.2007.0022 pmid: 17197403
[7] Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C . Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1 117 surgical extractions[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001,92(4):377-383.
doi: 10.1067/moe.2001.118284 pmid: 11598570
[8] Littner MM, Kaffe I, Tamse A , et al. Relationship between the apices of the lower molars and mandi-bular canal: a radiographic study[J]. Oral Surg Oral Med Oral Pathol, 1986,62(5):595-602.
doi: 10.1016/0030-4220(86)90326-9 pmid: 3466132
[9] Denio D, Torabinejad M, Bakland LK . Anatomical relationship of the mandibular canal to its surroun-ding structures in mature mandibles[J]. J Endod, 1992,18(4):161-165.
doi: 10.1016/S0099-2399(06)81411-1 pmid: 1402570
[10] Sato I, Ueno R, Kawai T , et al. Rare courses of the mandibular canal in the molar regions of the human mandible: a cadaveric study[J]. Okajimas Folia Anat Jpn, 2005,82(3):95-101.
doi: 10.2535/ofaj.82.95 pmid: 16350422
[11] Jun SH, Kim CH, Ahn JS , et al. Anatomical differen-ces in lower third molars visualized by 2D and 3D X-ray imaging: clinical outcomes after extraction[J]. Int J Oral Maxillofac Surg, 2013,42(4):489-496.
doi: 10.1016/j.ijom.2012.12.005 pmid: 23352698
[12] Castro R, Guivarc’h M, Foletti JM , et al. Endodontic-related inferior alveolar nerve injuries: a review and a therapeutic flow chart[J]. J Stomatol Oral Maxil-lofac Surg, 2018,119(5):412-418.
doi: 10.1016/j.jormas.2018.04.012 pmid: 29730463
[13] Knowles KI, Jergenson MA, Howard JH . Paresthesia associated with endodontic treatment of mandibular premolars[J]. J Endod, 2003,29(11):768-770.
doi: 10.1097/00004770-200311000-00019 pmid: 14651287
[14] Shin Y, Roh BD, Kim Y , et al. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report[J]. Restor Dent Endod, 2016,41(1):63-67.
doi: 10.5395/rde.2016.41.1.63 pmid: 26877992
[15] Olsen JJ, Thorn JJ, Korsgaard N , et al. Nerve lesions following apical extrusion of non-setting calcium hydroxide: a systematic case review and report of two cases[J]. J Craniomaxillofac Surg, 2014,42(6):757-762.
doi: 10.1016/j.jcms.2013.11.007 pmid: 24355358
[16] Serper A, Uçer O, Onur R , et al. Comparative neuro-toxic effects of root canal filling materials on rat sciatic nerve[J]. J Endod, 1998,24(9):592-594.
doi: 10.1016/S0099-2399(98)80116-7 pmid: 9922746
[17] Kim TS, Caruso JM, Christensen H , et al. A com-parison of cone-beam computed tomography and direct measurement in the examination of the mandi-bular canal and adjacent structures[J]. J Endod, 2010,36(7):1191-1194.
doi: 10.1016/j.joen.2010.03.028 pmid: 20630297
[18] Bastien AV, Adnot J, Moizan H , et al. Secondary surgical decompression of the inferior alveolar nerve after overfilling of endodontic sealer into the mandi-bular canal: case report and literature review[J]. J Stomatol Oral Maxillofac Surg, 2017,118(6):389-392.
doi: 10.1016/j.jormas.2017.09.001 pmid: 28893717
[19] Tilotta-Yasukawa F, Millot S, El Haddioui A , et al. Labiomandibular paresthesia caused by endodontic treatment: an anatomic and clinical study[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006,102(4):e47-e59.
doi: 10.1016/j.tripleo.2006.02.017 pmid: 16997095
[20] Scarano A, Di Carlo F, Quaranta A , et al. Injury of the inferior alveolar nerve after overfilling of the root canal with endodontic cement: a case report[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007,104(1):e56-e59.
doi: 10.1016/j.tripleo.2007.01.036 pmid: 17577544
[1] 廖洪林,方仲瀚,张艳艳,刘飞,沈颉飞. 牙种植术后三叉神经创伤性神经病理性疼痛的诊断与防治[J]. 国际口腔医学杂志, 2023, 50(6): 729-738.
[2] Huangphattarakul Vicha,满毅. 上颌窦提升中上颌窦黏骨膜穿孔的研究进展[J]. 国际口腔医学杂志, 2023, 50(5): 552-557.
[3] 王仁义,赵呈智,潘剑. 拔牙围手术期预防性使用抗生素对术后并发症影响的研究进展[J]. 国际口腔医学杂志, 2023, 50(5): 558-565.
[4] 高宇天,苏勤. 酸性氧化电位水在根管治疗中的研究与应用[J]. 国际口腔医学杂志, 2023, 50(4): 401-406.
[5] 杨雨楠,刘鹏,王虎,游梦. 上颌窦黏膜增厚的锥形束CT影像分析[J]. 国际口腔医学杂志, 2023, 50(3): 302-307.
[6] 李春洁, 毕小琴, 朱桂全. 口腔颌面部肿瘤患者游离皮瓣修复术的并发症预防及处理[J]. 国际口腔医学杂志, 2023, 50(2): 127-137.
[7] 汪牡丹,宋东哲,黄定明. 开髓洞型对患牙根管治疗术后抗折性能影响的研究进展[J]. 国际口腔医学杂志, 2023, 50(2): 186-194.
[8] 吴文智,冯达兴,陈垂壮,周丽鹃. 海口地区下颌第一恒磨牙近中中央根管发生率及相关因素[J]. 国际口腔医学杂志, 2022, 49(4): 420-425.
[9] 王璐璇,侯本祥. 根管内氢氧化钙残留对根管治疗的影响[J]. 国际口腔医学杂志, 2022, 49(3): 367-372.
[10] 叶泽林,刘璐,龙虎,游梦. 弯曲前牙的影像评价及治疗的研究进展[J]. 国际口腔医学杂志, 2022, 49(2): 173-181.
[11] 戢晓,景钫淇,李雅,薛晶. 根管预备顺序的数据模拟优化研究[J]. 国际口腔医学杂志, 2022, 49(1): 37-47.
[12] 何蓉,刘学军,周宇琨. 光子引导的光声流效应在根管荡洗中应用的系统评价[J]. 国际口腔医学杂志, 2021, 48(6): 644-655.
[13] 田浩楠,林敏,谢丛蔓,任嫒姝. 上颌腭侧阻生尖牙与寰椎后桥相关性的锥形束CT研究[J]. 国际口腔医学杂志, 2021, 48(5): 536-540.
[14] 邢桂琪,郭林溪,苏勤. 根管治疗后疾病的综合评估和治疗决策[J]. 国际口腔医学杂志, 2021, 48(5): 579-584.
[15] 施丹妮,杨鑫,吴建勇. 锥形束CT三维头影测量参考坐标系的研究进展[J]. 国际口腔医学杂志, 2021, 48(4): 398-404.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 康非吾. 种植义齿下部结构生物力学研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .