Biomaterial Database

Inferior alveolar nerve anaesthesia: A rare complication of orthodontic tooth movement. 2019

Hanya Mahmood, and Melanie Stern, and Simon Atkins

Department of Oral Surgery, School of Clinical Dentistry, Sheffield, UK.

Inferior alveolar nerve (IAN) damage is a rare but recognised complication of dental procedures including third molar surgery, implant surgery, endodontic treatment and local anaesthetic injections. However, it is rarely caused by orthodontic tooth movement. This report highlights a case of temporary IAN anaesthesia to the right mental region, which was likely to have occurred secondary to the orthodontic uprighting of a lingually tilted molar using a high strength arch wire. Immediate deactivation of the appliance and an acute reducing dose of systemic steroids resulted in complete resolution of symptoms. To the best of the author's knowledge, there have been seven previously described cases of IAN paraesthesia but no cases reporting IAN anaesthesia secondary to orthodontic fixed-appliance treatment. This case highlights the importance of dentists practising orthodontics to have an awareness of the clinical and radiographic signs that may indicate a high-risk case requiring appropriate referral for cone beam imaging and careful orthodontic planning. Furthermore, this case emphasises the need to warn high-risk patients of the symptoms of this rare complication and how it may be managed. This will ultimately help to minimise the risk of litigation and optimise patient experience and care.

UI	MeSH Term	Description	Entries
D008340	Mandibular Nerve	A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura.	Alveolar Nerve, Inferior,Auriculotemporal Nerve,Buccal Nerve,Deep Temporal Nerve,Lateral Pterygoid Nerve,Masseteric Nerve,Mental Nerve,Mylohyoid Nerve,Auriculotemporal Nerves,Buccal Nerves,Deep Temporal Nerves,Inferior Alveolar Nerve,Inferior Alveolar Nerves,Lateral Pterygoid Nerves,Mandibular Nerves,Masseteric Nerves,Mental Nerves,Mylohyoid Nerves,Nerve, Auriculotemporal,Nerve, Buccal,Nerve, Deep Temporal,Nerve, Inferior Alveolar,Nerve, Lateral Pterygoid,Nerve, Mandibular,Nerve, Masseteric,Nerve, Mental,Nerve, Mylohyoid,Pterygoid Nerve, Lateral,Pterygoid Nerves, Lateral,Temporal Nerve, Deep,Temporal Nerves, Deep
D008964	Molar, Third	The aftermost permanent tooth on each side in the maxilla and mandible.	Tooth, Wisdom,Teeth, Wisdom,Molars, Third,Third Molar,Third Molars,Wisdom Teeth,Wisdom Tooth
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000758	Anesthesia	A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D014081	Tooth Extraction	The surgical removal of a tooth. (Dorland, 28th ed)	Extraction, Tooth,Extractions, Tooth,Tooth Extractions
D014087	Tooth Movement Techniques	Orthodontic techniques used to correct the malposition of a tooth or teeth.	Tooth Depression,Tooth Intrusion,Tooth Movement, Minor,Tooth Uprighting,Orthodontic Tooth Movement,Depression, Tooth,Depressions, Tooth,Intrusion, Tooth,Intrusions, Tooth,Minor Tooth Movement,Minor Tooth Movements,Movement Technique, Tooth,Movement Techniques, Tooth,Movement, Orthodontic Tooth,Movements, Orthodontic Tooth,Orthodontic Tooth Movements,Technique, Tooth Movement,Techniques, Tooth Movement,Tooth Depressions,Tooth Intrusions,Tooth Movement Technique,Tooth Movement, Orthodontic,Tooth Movements, Minor,Tooth Movements, Orthodontic,Tooth Uprightings,Uprighting, Tooth,Uprightings, Tooth
D061221	Trigeminal Nerve Injuries	Traumatic injuries to the TRIGEMINAL NERVE. It may result in extreme pain, abnormal sensation in the areas the nerve innervates on face, jaw, gums and tongue and can cause difficulties with speech and chewing. It is sometimes associated with various dental treatments.	Cranial Nerve V Injury,Fifth Cranial Nerve Injuries,Fifth Cranial Nerve Injury,Fifth-Nerve Palsy, Traumatic,Fifth-Nerve Trauma,Injury, Cranial Nerve V,Injury, Fifth Cranial Nerve,Traumatic Fifth-Nerve Palsy,Trigeminal Nerve Avulsion,Trigeminal Nerve Contusion,Trigeminal Nerve Injury,Trigeminal Nerve Transection,Trigeminal Nerve Trauma,Trigeminal Neuropathy, Traumatic,Avulsion, Trigeminal Nerve,Avulsions, Trigeminal Nerve,Contusion, Trigeminal Nerve,Contusions, Trigeminal Nerve,Fifth Nerve Palsy, Traumatic,Fifth Nerve Trauma,Fifth-Nerve Palsies, Traumatic,Fifth-Nerve Traumas,Injuries, Trigeminal Nerve,Injury, Trigeminal Nerve,Nerve Avulsion, Trigeminal,Nerve Avulsions, Trigeminal,Nerve Contusion, Trigeminal,Nerve Contusions, Trigeminal,Nerve Injuries, Trigeminal,Nerve Injury, Trigeminal,Nerve Transection, Trigeminal,Nerve Transections, Trigeminal,Nerve Trauma, Trigeminal,Nerve Traumas, Trigeminal,Neuropathies, Traumatic Trigeminal,Neuropathy, Traumatic Trigeminal,Palsies, Traumatic Fifth-Nerve,Palsy, Traumatic Fifth-Nerve,Transection, Trigeminal Nerve,Transections, Trigeminal Nerve,Trauma, Fifth-Nerve,Trauma, Trigeminal Nerve,Traumas, Fifth-Nerve,Traumas, Trigeminal Nerve,Traumatic Fifth Nerve Palsy,Traumatic Fifth-Nerve Palsies,Traumatic Trigeminal Neuropathies,Traumatic Trigeminal Neuropathy,Trigeminal Nerve Avulsions,Trigeminal Nerve Contusions,Trigeminal Nerve Transections,Trigeminal Nerve Traumas,Trigeminal Neuropathies, Traumatic