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Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment
J Oral Med Pain 2011;36:199-205
Published online September 1, 2011
© 2011 Korean Academy of Orofacial Pain and Oral Medicine

Kook-Jin Bae, Jong-Mo Ahn, Chang-lyuk Yoon, Young-Gon Cho, Ji-won Ryu

조선대학교
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient’s condition with clinical neurosensory examination and current perception threshold test(Neurometer).
Keywords : Current perception threshold;Endodontic complication;Endodontic sealer;Gabapentin;Inferior alveolar nerve injuries;전류인지역치검사;근관치료 합병증;근관충전제;가바펜틴;하치조신경 손상


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