Management of a broken needle in the pterygomandibular space: report of case

Needle breakage following inferior alveolar nerve block: implications and management

“…[1][2][3] When it does happen, it is often a stressful event for the patient and dentist alike. This complication was, however, more frequent prior to the 1960s as evidenced by Blum's report of 100 cases in 1928 9 and Fraiser-Modie's review of 26 cases in 1958.…”

“…[1][2][3][4][5][6] It is well recognised that needle breakages are more common with a smaller diameter needle and often occur at the hub. [1][2][3][4][5][6][7][8] Though most dentists use a 27 gauge 35 mm (long) needle for administration of an inferior alveolar nerve block in an adult, there is occasionally a perception that the use of a thinner needle (30 gauge) is associated with less discomfort. It has however, been shown that there is little difference in the pain perception between the use of 27 and 30 gauge needles.…”

“…[1][2][3] This complication, however, continues to be reported infrequently and is thought to be due to poor practice, unexpected patient movement and needle manufacturing defects. [1][2][3][4][5][6][7][8] Needle breakage has most frequently been reported in relation to an inferior alveolar nerve block and the literature has mainly concentrated on elaborate needle localisation techniques.…”

“…[1][2][3][4][5][6][7][8] Needle breakage has most frequently been reported in relation to an inferior alveolar nerve block and the literature has mainly concentrated on elaborate needle localisation techniques. [1][2][3][4][5][6][7][8] We report the management of a patient with a broken needle in the pterygomandibular space and discuss the possible causes and preventative measures, the indications and timing of removal, modern modalities of localisation and a technique for needle retrieval. We also give advice for appropriate referral and documentation.…”

Arched Needle Technique for Inferior Alveolar Mandibular Nerve Block

“…Although, needle breakage remains a rare complication during oral local anesthesia (LA) administration, there are ample reports mandating a careful technique and precautionary measures to prevent this complication [1][2][3][4]. Chakranarayan and Mukherjee [5] describe a method of inferior alveolar nerve block (IANB) by injecting a local anesthetic solution into the pterygomandibular space by arching the needle and changing the approach angle of the conventional technique.…”