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Trigeminal nerve injuries
Author(s) -
Renton Tara
Publication year - 2018
Publication title -
australian endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.703
H-Index - 34
eISSN - 1747-4477
pISSN - 1329-1947
DOI - 10.1111/aej.12251
Subject(s) - medicine , inferior alveolar nerve , neuropathic pain , endodontics , trigeminal nerve , nerve injury , mandibular nerve , anesthesia , dentistry , molar
Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico‐legal implications. In trigeminal nerve injuries related to dentistry, 70% are reported to have chronic neuropathic post‐traumatic pain. Neuropathic pain states require different therapeutic approaches such as anticonvulsants, which are not effective in nociceptive pain. Major causes of nerve injuries in the orofacial region are endodontics and administration of local anaesthetics. Endodontic treatment of premolar and mandibular teeth has the potential to damage the inferior alveolar nerve via direct trauma, pressure or neurotoxicity. Persistent pain after endodontics has been reported to occur in 3–13% of patients, whilst surgical endodontics resulted in chronic neuropathic pain in 5% of patients. Most sensory nerve injuries related to dentistry are permanent; only local anaesthetic nerve injuries have a 75% likelihood of recovery. Nerve injury from local anaesthetics shows an incidence of 1 in 14 000 with 25% permanent injury from general dental restorative procedures and 1 in 3300 with 29% permanence from oral surgery.