Clinical investigation into the incidence of direct damage to the lingual nerve caused by local anaesthesia

Severe adverse reactions to dental local anaesthetics: prolonged mandibular and lingual nerve anaesthesia

“…2 Mepivocaine and bupivacaine are grouped, as not widely used in general dental practice. 19 A recent study based on voluntary reports in Ontario, Canada showed different incidence figures for different types of LA agents with 1 in 332 000 for prilocaine, 1 in 410 000 for articaine and 1 in 2 580 000 for lignocaine. 20 The main deficiency of this study's calculations of the incidence of prolonged anaesthetics was the refusal of the pharmaceutical companies and the supply houses to provide data on the quantity and type of local anaesthetics supplied to the profession.…”

Trigeminal nerve injuries in relation to the local anaesthesia in mandibular injections

“…[11][12][13][14][15][16][17][18][19][20][21] The nerve injury may be physical from the needle or chemical from the local anaesthetic solution. The mean age of patients presenting with trigeminal nerve injury in relation to LA in our study was 48 years, similar to that of previous studies.…”

Lingual nerve injury following surgical removal of mandibular third molar

“…In our study out of 116 patients, one patient (0.9%) was diagnosed with lingual nerve paresthesia; this patient encountered the sensation of an unpleasant electric shock" on insertion of the needle for an inferior alveolar nerve block due to the fact the needle has come into contact with the nerve. Estimates indicate a prevalence of transiently impaired lingual and inferior alveolar nerve function ranging in the order of the size of 0.15-0.54% 12,13 whereas permanent injury caused by injection of local analgesics is much less frequent, 0.0001-0.01%. 12,14,15 Various views have been expressed to explain the mechanism of nerve injury after anesthetic injection.…”

“…17 Direct physical fascicular damage can be resulting from a penetrating injection needle, or by way of a damaged injection needle on withdrawal after bone contact. 12,13,16 Intraneural bleeding may exert pressure, and subsequent constrictive scarring may obstruct nerve conduction. 17 Finally, Hass and Lennon 15 stated that local anesthetic formulations might show the capacity to develop neurotoxicity, specifically Articaine 4% and Prilocaine 3-4%.…”