Central and peripheral nervous complications of dental treatment

Complicações de tratamento dentário afetando o sistema nervoso

Central and peripheral nervous complications of dental treatment

Complicações de tratamento dentário afetando o sistema nervoso

Eva Olovsson Rossitti

Dentist

SUMARY

This review outlines the complications involving the central or peripheral nervous system arising from dental procedures reported in the last decade. By far the commonest complications were related to intraoperative mechanical peripheral nerve injury. Trauma to branches of the mandibular nerve occuring during oral operations may potentially result in varying degrees of hypoesthesia, paresthesia, dysesthesia or in chronic pain syndromes. An increase in malpractice suits related to such a complication has been recognized in the late years. A warning of the possibility of occurrence of this complication should to be given to all patients undergoing risky procedures as part of the process of obtaining informed consent to operation. Mandibular third molar extraction seems to be alone the most hazardous procedure related to mechanical nerve injuries and also with anesthesiological accidents. Severe but rather infrequent infectious (meningitis, brain abscess and cavernous sinus thrombophlebitis) and anesthesiological complications (occular and facial palsies, optic nerve injury and complications related to general anesthesia) were also reported in this period.

Key words:anesthesia, dental, adverse effects; dental, complications; dentistry, operative; inferior alveolar nerve, injury; lingual nerve, injury; nerve block, adverse effects; sensation disorders, etiology; third molar; tooth extraction, adverse effects.

RESUMO

Complicações, ou eventos inesperados e indesejáveis associados a terapia de uma dada condição, podem ser particularmente incapacitantes quando afetam o sistema nervoso. A proximidade de cavidade craniana e a rica inervação dos tecidos orais representam risco potencialmente alto de disseminação de infecções para o sistema nervoso central e de lesões de troncos nervosos em procedimentos dentários. Em vista do aumento da ocorrência de processos para compensação financeira após tais complicações, é provável que parcela considerável desses pacientes venham a ser examinados por neurologistas. As complicações de tratamento dentário afetando o sistema nervoso central e periférico referidas na literatura (1982-1994) são tema desta revisão. As complicações mais comuns foram as lesões dos ramos da divisão mandibular do nervo trigêmeo provocadas por trauma mecânico. A extração do terceiro molar mandibular foi o procedimento dentário com maior morbidade tanto com relação a trauma mecânico quanto a acidente anestésico. Nesse procedimento o nervo lingual pode ser traumatizado em 11% a 15% das operações e o nervo alveolar inferior em 4,4% a 5,5%. Os sintomas são permanentes em 0,5% a 1,0%. Outras complicações potencialmente severas porém infrequentes no período estudado foram as infecções (meningite, tromboflebite do seio cavernoso e abscesso cerebral) e as complicações anestésicas (oftalmoplegia, paralisia facial e complicações da anestesia geral).

Palavras-chave: anestesia dental, complicações; bloqueio nervoso, complicações; cirurgia bucomaxilofacial; dor facial, etiologia; extração dental, complicações; nervo alveolar inferior; nervo lingual; terceiro molar.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Acknowledgement - To my husband Sandro Rossitti for stimulating criticism and support.

Aceite: 4-janeiro-1995

Eva Olovsson Rossitti - Nordenskiöldsgatan 6 - S-413 09 Göteborg - Sweden

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Publication Dates

• Publication in this collection
  09 Dec 2010
• Date of issue
  Sept 1995