Nerve lesions following apical extrusion of non-setting calcium hydroxide: a systematic case review and report of two cases.

J J Olsen, J J Thorn, N Korsgaard, E M Pinholt

Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2015;42(6):757-62

PMID: 24355358

Full Text on Elsevier Science View on PubMed

Abstract

We present two cases of apical extrusion of non-setting, calcium hydroxide paste which had been placed as an interappointment root canal dressing during routine endodontic treatment resulting in tissue necrosis of a large part of the mandible. Surgical intervention consisted of resections in both instances. In relation to the cases presented, a systematic review of similar cases in the literature between 1980 and April 2013 was conducted which resulted in eight cases meeting the criteria outlined. As with the two presented cases, half of these eight cases showed serious adverse effects and the use of an injectable system had most often been related to apical extrusion. Consequently, great care should be taken when applying the paste into the canal system.

Address: University of Copenhagen, Institute of Odontology, Department of Oral and Maxillofacial Surgery, 20, Nørre Allé, DK-2200 Copenhagen N, Denmark.; Department of Oral and Maxillofacial Surgery, Hospital of South West Jutland, Esbjerg, Denmark.; Clinical Diagnostic Center, Hospital of South West Jutland, Esbjerg, Denmark.; University of Copenhagen, Institute of Odontology, Department of Oral and Maxillofacial Surgery, 20, Nørre Allé, DK-2200 Copenhagen N, Denmark. Electronic address: [email protected].

DOI: 10.1016/j.jcms.2013.11.007

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MeSH Terms: Adult, Calcium Hydroxide, Foreign Bodies, Humans, Male, Mandibular Diseases, Mandibular Nerve, Middle Aged, Necrosis, Osteonecrosis, Paresthesia, Periapical Tissue, Pulpectomy, Root Canal Irrigants, Tooth Apex, Trigeminal Nerve Injuries