CASE PRESENTATION:FRACTURED NEEDLE IN THE PTERYGOMANDIBULAR SPACE AFTER AN INFERIOR ALVEOLAR NERVE BLOCK

Abstract

Needle fracture during inferior alveolar nerve block is a very rare accident that can occur in the dental private practice. The incidence is reported to represent approximately 0,000007%. A fractured needle in the pterygomandibular area is considered an emergency so it is important to withdraw it. Although images like panoramic radiography (2D) and computed tomography (3D), are useful in the localization of the foreign body the removal can be very difficult. In this article we present the case of a 32 year old male patient, who experienced an inferior alveolar nerve block for the endodontic treatment of the tooth 47 at a private dental office. During the nerve block on the right side, a 30 G disposable needle tore and shifted posteriorly in the pterygomandibular space. We managed a successful outcome, in general anaesthesia with oro tracheal intubation. The needle removal was possible with the aid of the department of interventional radiology which provided imagistic support with guided fluoroscopy.

Keywords

• needle fracture
• inferior alveolar nerve block
• guided fluoroscopy