J Korean Dent Soc Anesthesiol.  2010 Dec;10(2):172-177. 10.17245/jkdsa.2010.10.2.172.

Study for Inferior Alveolar and Lingual Nerve Damages Associated with Dental Local Anesthesia

• Lee BH
• Im TY
• Hwang KG
• Seo MS
• Park CJ

• KMID: 2345083
• DOI: http://doi.org/10.17245/jkdsa.2010.10.2.172

Abstract

BACKGROUND
Damages of trigeminal nerve, particularly inferior alveolar nerve and lingual nerve, could occur following dental procedures. In some cases, nerve damage may happen as a complication of the local anesthetic injection itself and not of the surgical procedure.
METHODS
From September 2006 to August 2010, 5 cases of inferior alveolar nerve and lingual nerve damages, which were assumed to happen solely due to local anesthesia, were reviewed. All cases were referred to Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University Medical Center for legal authentication in the process of criminal procedure.
RESULTS
In all five cases, patients complained of altered sensation occurred in the distribution of the inferior alveolar or lingual nerve following block anesthesia. The local anesthetics were 2% lidocaine with 1 : 100,000 epinephrine and the amount of local anesthetics, which were used during injection, were varied. Most of patients experienced the electric stimulation during injection. Recovery was poor and professional supportive care was mostly absent.
CONCLUSIONS
Dental practitioners should consider that the surgical procedure caused the trigeminal nerve damage, however, dental local anesthesia for inferior alveolar nerve and lingual nerve could be one of the causes for damages. The various mechanisms for nerve damages by local anesthesia are thoroughly discussed.

Keyword

Anesthesia; Local; Dental care; Neurotoxicity; Trigeminal nerve diseases

MeSH Terms

Academic Medical Centers
Anesthesia
Anesthesia, Local*
Anesthetics, Local
Criminals
Dental Care
Dentistry
Electric Stimulation
Epinephrine
Humans
Lidocaine
Lingual Nerve*
Mandibular Nerve
Sensation
Surgery, Oral
Trigeminal Nerve
Trigeminal Nerve Diseases
Anesthetics, Local
Epinephrine
Lidocaine