Removal of a fractured needle during inferior alveolar nerve block: two case reports

You, Jun; Kim, Su-Gwan; Oh, Ji‐Su; Choi, Hyoung Gwon; Jih, Myeongkwan

doi:10.17245/jdapm.2017.17.3.225

Cited by 9 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main indications for removing the fragment in the case reports in question were the pain and trismus generated by the local inflammatory response, in addition to the psychological changes of the patients and the risk of injury to adjacent noble structures. 8,9 Among the regions of the oral cavity, the maxilla is the least incident. 4 In contrast, the pterygomandibular space is the most affected local and buccinator muscle, in addition to the inferior alveolar nerve, the lingual nerve and homonymous vessels.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

Couto¹,

Silva²,

Saboia³

et al. 2021

Clin Lab Res Dent

View full text Add to dashboard Cite

Introduction: Accidents and complications are elements that can occasionally be associated with the procedures realized within work dentist environment. Among some accidents related to dental practice, needle fracture during local anesthesia is noteworthy due to its rarity. Objective: This work seeks to report two cases of removal of a broken dental needle in the pterygomandibular space using an image intensifier. Material and Methods: In both cases, the accident happened during an inferior alveolar nerve block. The surgeons requested image exams to locate the objects using general anesthesia. In the surgery, a transoral incision was made to remove the broken needle from the pterygomandibular space, guided by an image intensifier. Results: Both surgeries were a success. The broken needles were found quickly with the use of the image intensifier, and no postoperative complications were observed. Conclusion: The correct assessment of fractured dental position is essential for its removal. The use of the image intensifier has been showing advantages, such as offering fast transoperative dynamic images and at different angles, thus providing opportunity for calmer surgery and with less risk for the patient and the operator.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, the operator must maintain cautious pressure to displace the fractured object. 9 In the present case, an image intensifier (fluoroscopy) was used. It is a radiographic method by which the structures can be observed in their dynamics.…”

Section: Discussionmentioning

confidence: 99%

Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

Couto¹,

Silva²,

Saboia³

et al. 2021

Clin Lab Res Dent

View full text Add to dashboard Cite

show abstract

“…The latter factor is of exceptional importance, as it results from the desire to minimize the pain of the injection, although it has been proven that the pain caused by the injection does not depend on the diameter of the needle. In addition, thinner needles are prone to cause more pain because the pressure applied on the syringe is much greater with a small gauge needle, so it is advisable to use a 27-gauge 21 mm needle, instead of a 30-gauge 21 mm needle, for young patients who have low pain threshold [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Computer-Controlled Local Anesthesia Complication: Surgical Retrieval of a Broken Dental Needle in Noncooperative Autistic Paediatric Patient

Chybicki

Lipczyńska-Lewandowska

Torbicka

et al. 2020

Case Reports in Dentistry

View full text Add to dashboard Cite

The article describes an unusual case of retrieval of 8 mm fragment of a broken 30-gauge 21 mm dental needle in a 6 y.o. noncooperative autistic male patient. The needle of a computer-controlled local anesthesia device was broken during an attempt to administer local anesthetic, in order to perform conservative treatment of teeth 55 and 54 by a pedodontist. Despite the fact that the patient was under nitrous oxide sedation, an unexpected movement of the patient occurred and resulted in needle breakage. Due to the lack of patient cooperation, the surgical retrieval of a broken needle was performed under general anesthesia as part of one-day surgery procedures. The purpose of the article is to emphasize careful decision-making in proper choice of dental instruments during treatment of noncooperative paediatric patients even under sedation and to suggest dentists to carry out treatment of such patients under general anesthesia.

show abstract

“…The inferior alveolar, lingual and buccal nerve block technique is the most used in dentistry when we think about an intra-oral surgical procedure in the mandible. However, it is one of the techniques that present the most complications, namely: paresthesia, hematomas and needle fracture (You, Kim, Oh, Choi & Jih, 2017). It is estimated that for every 14 million local anesthesia there is one case of needle fracture (Pogrel, 2009), and about 70% of fractures occur during the inferior alveolar, lingual and buccal nerve block technique (Lukas, Jan, Constantinus & Paul, 2020).…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopy for intraoral removal of fractured needle

Pierri¹,

Sigua-Rodríguez²,

Camarini³

et al. 2023

Rev. Uningá

View full text Add to dashboard Cite

There are few reports in the literature concerning needle fractures during the local administration of anesthetic solution in dental procedures. However, the risk still exists. The patient’s unexpected movement during anesthesia, bending the needle prior to its use in the tissue, incorrectly performed anesthetic technique, uncooperative patient, small needle diameter or size may be considered substantial risks of fracture. At the moment the needle fracture occurs in the tissues it can move to the patient’s vital regions, and it is of utmost importance to remove it. If it is not possible to remove the needle immediately, an oral surgeon should be contacted to remove it under general anesthesia at the hospital. This paper aims to report a case of needle fracture in third molar exodontia during lower alveolar, lingual and buccal right nerve block, referred to the oral and maxillofacial surgery and traumatology department of the State University of Maringá. After clinical examination and tomography assessment, the patient underwent a surgical procedure to remove the needle in the operating room under general anesthesia and aid of trans-operative fluoroscopy. Therefore, we conclude that fluoroscopy is an extremely important resource in cases such as this one, since it allows a guided procedure, reducing the surgical trauma of an exploratory surgery.

show abstract

Removal of a fractured needle during inferior alveolar nerve block: two case reports

Cited by 9 publications

References 9 publications

Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

Computer-Controlled Local Anesthesia Complication: Surgical Retrieval of a Broken Dental Needle in Noncooperative Autistic Paediatric Patient

Fluoroscopy for intraoral removal of fractured needle

Contact Info

Product

Resources

About