During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

Citations

Citations to this article as recorded by  

• Automatic localization of inferior alveolar nerve canal in panoramic dental images
  Uma Maheswari Pandyan, Banumathi Arumugam, Ulaganathan Gurunathan, Shahul Hameed Kopuli Ashkar Ali
  Signal, Image and Video Processing.2022; 16(5): 1389.     CrossRef
• Inferior alveolar nerve injury due to the extrusion of calcium hydroxide during endodontic treatment: A case report
  Metin Berk Kasapoğlu, Gülce Ecem Doğancalı
  Australian Endodontic Journal.2022; 48(2): 342.     CrossRef
• Inferior alveolar nerve canal segmentation by local features based neural network model
  P. Uma Maheswari, A. Banumathi, G. Ulaganathan, R. Yoganandha
  IET Image Processing.2022; 16(3): 703.     CrossRef
• Microsurgical Repair of Inferior Alveolar Nerve Injuries Associated With Endodontic Treatment: Results on Sensory Function and Relief of Pain
  Keith A. Sonneveld, Kristopher L. Hasstedt, Roger A. Meyer, Shahrokh C. Bagheri
  Journal of Oral and Maxillofacial Surgery.2021; 79(7): 1434.     CrossRef
• The significance of diagnosis and treatment planning in periapical lesion overfilled with calcium hydroxide paste
  Kyoung-Hwa Jung, Eun-Young Kwon, Youn-Kyung Choi, So-Yeun Kim, Hye-Mi Jeon, Jeong-Kil Park
  Journal of Dental Rehabilitation and Applied Science.2021; 37(2): 95.     CrossRef
• The anatomical relationship between the roots of erupted permanent teeth and the mandibular canal: a systematic review
  Michał Puciło, Mariusz Lipski, Magdalena Sroczyk-Jaszczyńska, Aleksandra Puciło, Alicja Nowicka
  Surgical and Radiologic Anatomy.2020; 42(5): 529.     CrossRef
• Massive extrusion of calcium hydroxide paste containing barium sulphate during endodontic treatment
  Jéssica Montenegro Fonsêca, Natália Rangel Palmier, Gleyson Kleber Amaral‐Silva, Lady Paola Aristizabal Arboleda, José Flávio Affonso Almeida, Mario Fernando de Goes, Pablo Agustin Vargas, Marcio Ajudarte Lopes, Alan Roger Santos‐Silva
  Australian Endodontic Journal.2020; 46(2): 257.     CrossRef
• The double-edged sword of calcium hydroxide in endodontics
  Alan H. Gluskin, Gordon Lai, Christine I. Peters, Ove A. Peters
  The Journal of the American Dental Association.2020; 151(5): 317.     CrossRef
• Endodontic-related inferior alveolar nerve injuries: A review and a therapeutic flow chart
  R. Castro, M. Guivarc'h, J.M. Foletti, J.H. Catherine, C. Chossegros, L. Guyot
  Journal of Stomatology, Oral and Maxillofacial Surgery.2018; 119(5): 412.     CrossRef
• Relationship between Root Apices and the Mandibular Canal: A Cone-beam Computed Tomographic Comparison of 3 Populations
  Alex Lvovsky, Shir Bachrach, Hyeon-Cheol Kim, Ajinkya Pawar, Oleg Levinzon, Joe Ben Itzhak, Michael Solomonov
  Journal of Endodontics.2018; 44(4): 555.     CrossRef
• A case of high density abnormality in x-ray findings of mandible caused by leakage of root canal filling paste
  Haruko Kashiwamura, Kyoko Oka, Yoko Tuchihashi, Hanako Yoshioka, Mayumi Kato, Atsuko Baba, Toyohiro Kagawa, Kazuhiko Okamura, Masao Ozaki
  Pediatric Dental Journal.2017; 27(3): 162.     CrossRef
• Oral dysesthesia
  Christopher J. Spencer, Gary D. Klasser
  The Journal of the American Dental Association.2017; 148(12): 941.     CrossRef
• Microsurgical Decompression of Inferior Alveolar Nerve After Endodontic Treatment Complications
  Bernardo Bianchi, Andrea Ferri, Andrea Varazzani, Michela Bergonzani, Enrico Sesenna
  Journal of Craniofacial Surgery.2017; 28(5): 1365.     CrossRef