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| Title |
Overfilling Of Root Canal Materials Into The Mandibular Canal Shows High Incidence Of Paresthesia |
| Clinical Question |
What is the likelihood of paresthesia following overfilling of root canal obturating materials into the mandibular nerve canal? |
| Clinical Bottom Line |
The overall incidence of some degree of paresthesia following radiographic evidence overfilling of root canal materials into the mandibular canal was 87%. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 17197403 | Pogrel/2007 | 61 humans | Case Series | | Key results | Sixty-one subjects were evaluated over an 8 year period for root canal overfilling into the mandibular canal. Fifty patients received no further treatment subsequent to the overfill evaluation, 8 never became symptomatic and only 4 of the remaining 42 had resolution of symptoms. Eleven patients underwent additional procedures (surgical intervention) to treat the parethesia/dysethesia. Five patients underwent surgery within 48 hours of injury and all experienced total resolution of parethesia during unspecified follow up. Six patients underwent surgical intervention a week or more following injury. Four achieved partial improvement, 2 no improvement, and all 6 never achieved total resolution of symptoms. | |
| Evidence Search |
("Root Canal Filling Materials"[Mesh] AND "Root Canal Therapy"[Mesh]) AND "Paresthesia"[Mesh] AND ("humans"[MeSH Terms] AND English[lang]) |
Comments on
The Evidence |
There are not high levels of evidence regarding this question. The majority of published articles are single case reports. The above study is the largest case series on the issue. It has a single oral surgeon providing treatment. The study had the highest subject number, but had no mention of specific follow up timelines, and the treatment options presented in the article represent the opinion of the author. Thus, they may not be standardized throughout the oral surgery profession. The current best evidence is weak on this subject and the results must be interpreted with caution. |
| Applicability |
The results may apply to anyone who is undergoing root canal therapy of the mandibular posterior teeth and has radiographic evidence of overfilling of root canal materials into the mandibular canal. |
| Specialty/Discipline |
(Endodontics) (General Dentistry) |
| Keywords |
Mandibular nerve paresthesia, root canal, overfilling
|
| ID# |
2083 |
| Date of submission: |
09/08/2011 |
| E-mail |
dietrichm@livemail.uthscsa.edu |
| Author |
Matthew Dietrich |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Fabricio Teixeira, DDS, MS, PhD |
| Faculty mentor/Co-author e-mail |
fabricio-teixeira@uiowa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Liliana Paz, Jennifer Diep (San Antonio, TX) on 11/30/2017
While there is an abundance of new case reports of patients that exhibit paresthesia due to overfilling of the root canal into the mandibular canal, there is still not a lot of high level of evidence available on its exact incidence. A search of the literature was done in November 2017 and a systematic review was found (Alves/2014; PMID: 24598329) that does not corroborate Dietrich's findings. Dietrich reported on a case series in which there was an 87% incidence of paresthesia after overfilling of root canal materials into the mandibular canal; however, this systematic review is more recent and concluded that the incidence of endodontic-related paresthesia is still unknown. | |
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