A case series of trigeminal nerve injuries caused by periapical lesions of mandibular teeth

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A case series of trigeminal nerve injuries caused by periapical lesions of mandibular teeth
Key Take-Away: 

Periapical lesions of mandibular teeth can lead to induction of mandibular trigeminal sensory epithelium. This study explained that numbness, pain and paraesthesia are experienced by the patients suffering from TNI due to periapical lesions. These injuries can be managed by early diagnosis and treatment of these lesions.

Periapical lesions have been implicated in mandibular trigeminal sensory neuropathy. 

ABSTRACT: 
Background: 

Periapical lesions have been implicated in mandibular trigeminal sensory neuropathy.

This study aimed to report on a case series of consecutive patients presenting with mandibular division trigeminal nerve injuries (TNI) caused by periapical lesions. Common presenting characteristics and possible strategies for management were also investigated.

Methods: 

A retrospective study of 22 patients with TNI caused by periapical lesions.

Data were extracted from patient records and analyzed using Microsoft Excel and SPSS. Factors associated with TNI resolution were assessed using Student's t-Tests and one-way Analysis of Variance (ANOVA), where P <0.05 indicated statistical significance.

Results: 

Twenty-one patients had inferior alveolar nerve injuries (IANI) and one had a lingual nerve injury (LNI).

The most commonly affected teeth were the first molars (11 patients; 50%). TNI symptoms included numbness, pain and/or paraesthesia. IANI resolved completely among five patients within a mean time of 4.7 months (range 1.5–12 months). Patients who showed complete resolution had the affected teeth extracted or primary endodontic treatment with antibiotics.

Conclusion: 

Patients with TNI caused by periapical lesions can suffer significantly from combined numbness, pain and paraesthesia.

Resolution of these injuries may be maximized upon early diagnosis and treatment of the periapical lesion by tooth extraction or primary endodontic treatment.

Source:

British Dental Journal

Link to the source:

http://www.nature.com/bdj/journal/v222/n6/abs/sj.bdj.2017.268.html

Original title of article:

A case series of trigeminal nerve injuries caused by periapical lesions of mandibular teeth

Authors:

M. Devine et al.

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