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Early diagnosis and treatment of the periapical lesions should be encouraged in patients withTNI as they might suffer from combined numbness, pain and paraesthesia.
According to a recent case series published in British Dental Journal patients with trigeminal nerve injuries (TNI) caused by periapical lesions tend to suffer significantly from combined numbness, pain, and paraesthesia.
Periapical are known to associated with mandibular trigeminal sensory neuropathy. The present study carried out to report a case series of consecutive patients presented with mandibular division TNI caused by periapical lesions.
An investigation was made to study common characteristics and possible strategies for management. A backdated study of 22 patients with TNI caused by periapical lesions was carried, and the data were collected from patient records and inspected using Microsoft Excel and SPSS. Student's t-tests and One-way Analysis of Variance (ANOVA) methods were employed to assess the factors associated with TNI resolution where p<0.05 indicated statistical significance.
Results indicated that 21 patients were suffering from 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%), and numbness, pain and/or paraesthesia symptoms were seen in patients with TNI. IANI resolved completely among 5 patients within a mean time of 4.7 months (range 1.5–12 months). Complete resolution was indicated in patients with affected teeth extracted or primary endodontic treatment with antibiotics.
It was concluded that patients with TNI caused by periapical lesions could suffer significantly from combined numbness, pain, and paraesthesia. Early diagnosis and treatment of periapical lesion by tooth extraction or primary endodontic treatment could increase the resolution of these injuries.
British Dental Journal
A case series of trigeminal nerve injuries caused by periapical lesions of mandibular teeth
M. Devine et al
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