J Dent Rehabil Appl Sci.  2016 Jun;32(2):123-129. 10.14368/jdras.2016.32.2.123.

Management for traumatic neuropathy after dental treatment

• Jeong SH
• Lee S
• Ahn YW
• Heo JY
• Jeon HM
• Ok SM

• KMID: 2328894
• DOI: http://doi.org/10.14368/jdras.2016.32.2.123

Abstract

Whereas a somatic pain notifies tissue damage, a neuropathic pain presents disorder of the nerve itself. The causes of neuropathic pains are trauma, infection, chronic irritation by adjacent tissue and so on. The iatrogenic trauma or infection also causes traumatic neuropathy, which may exert a bad influence on doctor-patient relationship. Some of related dental treatments are implantation (directly or indirectly through heating), root canal treatment, teeth extraction, block anesthesia, mandibular surgery. If inappropriate management is performed after nerve trauma, there will be many chances to develop chronic neuropathy for the patient. It is important that the sign of nerve trauma have to be caught by the practitioner as soon as possible and treated properly.

Keyword

traumatic neuropathy; Iatrogenic trauma

MeSH Terms

Anesthesia
Dental Pulp Cavity
Humans
Neuralgia
Nociceptive Pain
Tooth

Figure

• 

  Fig. 1 The related part of the panoramic view of the 1st case, which shows #47i, 46i and recently extracted #45i site.

• 

  Fig. 2 Dental CBCT coronal views of #47i (A), #46i (B), #45i extraction site (C). The arrows are pointing the mandibular canal.

• 

  Fig. 3 The related part of the panoramic view of the 2nd case, which shows #38 extraction site.

• 

  Fig. 4 Drawings of the paresthetic areas from the clinical chart of the 1st visit (A) and after 2 months (B).

• 

  Fig. 5 A panoramic view of the 3rd case which shows implantations on all over the lower alveolar ridge.

• 

  Fig. 6 Dental CBCT coronal views of #47i (A), #46i (B), #44i (C). The arrows are pointing the mandibular canal.

Reference

References

1. Merskey HE. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl. 1986; 3:S1–226.

2. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951; 74:491–516. DOI: 10.1093/brain/74.4.491. PMID: 14895767.

3. Seddon HJ. Three types of nerve injury. Brain. 1943; 66:247–88. DOI: 10.1093/brain/66.4.237.

4. Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. 2011; 2:e1. DOI: 10.5037/jomr.2011.2101. PMID: 24421983. PMCID: PMC3886063.

5. Abarca M, van Steenberghe D, Malevez C, De Ridder J, Jacobs R. Neurosensory disturbances after immediate loading of implants in the anterior mandible: an initial questionnaire approach followed by a psychophysical assessment. Clin Oral Investig. 2006; 10:269–77. DOI: 10.1007/s00784-006-0065-0. PMID: 16937108. PMCID: PMC1705496.

6. Benoliel R, Sharav Y. Chronic orofacial pain. Curr Pain Headache Rep. 2010; 14:33–40. DOI: 10.1007/s11916-009-0085-y. PMID: 20425212.

7. Yoon JA, Kang JK, Ahn HJ, Choi JH, Kim CY. A study on types and counterplans of medical accident experienced by dentists in Seoul (2004). J Oral Med Pain. 2005; 30:163–200.

8. Han SR, Yeo SP, Lee MK, Bae YC, Ahn DK. Early dexamethasone relieves trigeminal neuropathic pain. 2010; 89:915–20.

9. Alves FR, Coutinho MS, Gonçalves LS. Endodontic-related facial paresthesia: systematic review. J Can Dent Assoc. 2014; 80:e13. PMID: 24598329.

10. Libersa P, Savignat M, Tonnel A. Neurosensory disturbances of the inferior alveolar nerve: a retrospective study of complaints in a 10-year period. J Oral Maxillofac Surg. 2007; 65:1486–9. DOI: 10.1016/j.joms.2007.03.023. PMID: 17656272.

11. Peñarrocha Diago M, Boronat López A, Lamas Pelayo J. Update in dental implant periapical surgery. Med Oral Patol Oral Cir Bucal. 2006; 11:E429–32. PMID: 16878068.

12. Galloway EB 3rd, Jensen RL, Dailey AT, Thompson BG, Shelton C. Role of topical steroids in reducing dysfunction after nerve injury. Laryngoscope. 2000; 110:1907–10. DOI: 10.1097/00005537-200011000-00026. PMID: 11081608.

13. Jancsó G, Kiraly E, Jancsó-Gábor A. Pharmacologically induced selective degeneration of chemosensitive primary sensory neurones. Nature. 1977; 270:741–3. DOI: 10.1038/270741a0. PMID: 593396.

14. Kohnelein KE, Ocker K, Seitz HD. Experimental rails to inhibit neuroma formation. Chir Plast (Berl). 1980; 5:207–11.