Year 2017,
Volume: 3 Issue: 1, 27 - 33, 01.04.2017
Gökhan Gürler
Çağrı Delilbaşı
İpek Kaçar
Abstract
İğne kırılması dental anestezi sırasında nadir görülen bir komplikasyondur. Daha çok Nervus alveolaris inferior blokajı sırasında oluşur, ancak maksiller enjeksiyonlar sırasında görülen az sayıda olgu bildirimleri de mevcuttur. İğne kırılması önlenebilir pek çok farklı nedenlerle oluşabilir. İleri radyolojik teknikler kırılan iğne parçasının yerinin kesin olarak belirlenmesinde faydalıdır. Kırılan parçanın yumuşak dokular içinde hareket etmesi nedeniyle cerrahi olarak çıkartılması önerilmektedir. Bu olguda maksiller dental anestezi sırasında kırılan iğne parçasının radyografik özellikleri ve cerrahi olarak çıkartılması sunulmuştur. Bunun yanı sıra, dental anestezi sırasında iğne kırılmasına yönelik literatür derlemesi amaçlanmaktadır
References
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Baur DA, Quereshy FA, Teich ST, Gonzalez
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for inferior alveolar anesthesia. Gen Dent
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pterygomandibular space. Four case reports.
Minerva Stomatol 2013;62(11-12):455-63.
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Allard RH. [Needle breakage during
mandibular block anaesthesia: prevention
and retrieval]. Ned Tijdschr Tandheelkd.
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BT, Krug B, Klesper B, Zöller JE. Image
guided surgical navigation for removal
of foreign bodies in the head and neck.
J Craniomaxillofac Surg 2001;29(6):321-5.
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A. Management of a needle breakage
during third molar extraction with C-ARM
digital fluoroscope. J Craniofac Surg.
201;23(5):1583-4.
- [15] Bacci C, Mariuzzi ML, Ghirotto C, Fusetti
S. Local anesthesia needle breakage in a
5-year-old child during inferior alveolar
nerve block with the Vazirani-Akinosi
technique. Minerva Stomatol.
2012;61(7-8):337-40.
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Berrone S. Management of needle breakage
using intraoperative navigation following
inferior alveolar nerve block. J Oral
Maxillofac Surg. 2013;71(11):1819-24.
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et al: Temporary intermaxillary fixation using
individualized acrylic splints permits imagedata-based
surgery of the lower jaw and
oropharynx. Laryngoscope 114:1506, 2004
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foreign bodies after penetrating gunshot
wounds: Retrospective analysis of 22 cases
and clinical review. Minim Invasive
Neurosurg 42:207, 1999
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al: Computed intraoperative navigation
guidance: A preliminary report on new
technique. Br J Oral Maxillofac Surg
35:271, 1997
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in the pterygomandibular space following
a Vazirani-Akinosi block: case report.
J Can Dent Assoc. 2011;77:64.
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use of a metal detector for localisation
of a metallic foreign body in the floor
of the mouth. Br J Oral Maxillofac Surg
1993;31(3):191-2.
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of broken instrument removed from
field of operation by an electromagnet.
Br J Oral Maxillofac Surg 1987;25(3):265-6.
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of an electromagnet to retrieve a
broken fascia needle during frontalis
sling surgery. Ophthal Plast Reconstr Surg
2005;21(6):469-70.
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in the pterygomandibular space. Report of a
case. Oral Surg Oral Med Oral Pathol
1973;36(5):750-2.
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MF. Retrieval of a broken needle in the
pterygomandibular space. J Am Dent Assoc
1999;130(5):685-7.
- [26] Ho KH. A simple technique for localizing
a broken dental needle in the
pterygomandibular region. Aust Dent
J 1988;33(4):308-9.
- [27] Crouse VL. Migration of a broken anesthetic
needle: report of a case. S C Dent J
1970;28(9):16-9.
- [28] Amies A.B. Broken needles Aust J Dent
1951;55403–406.
- [29] Fraser-Moodie W. Location and localisation
of metal in the tissues Br J Oral Surg
1966; 499–105
- [30] Thompson M, Wright S, Cheng LH, Starr D.
Locating broken dental needles. Int J Oral
Maxillofac Surg 2003;32(6):642-4.
- [31] Ethunandan M, Tran AL, Anand R, Bowden
J, Seal MT, Brennan PA. Needle breakage
following inferior alveolar nerve block:
implications and management. Br Dent J
2007 14;202(7):395-7.
- [32] Nezafati S, Shahi S Removal of broken
dental needle using mobile digital C-arm.
J Oral Sci 2008;50(3):351-3.
- [33] Faura-Solé M, Sánchez-Garcés MA,
Berini-Aytes L, Gay-Escoda C.
Broken anesthetic injection needles: report
of 5 cases. Quintessence Int 1999l;30(7):461-5.
- [34] Kronman JH, el-Bermani AW, Wongwatana
S, Kumar A. Preferred needle lengths for
inferior alveolar anesthesia. Gen Dent
1994;42(1):74-6.
- [35] Philbert R, Hamilton B, Zola M. Management
of needle breakage using intraoperative
navigation following inferior nerve block.
J Oral Maxillofac Surg 2014;72(4):653.
- [36] Brownbill JW, Walker PO, Bourcy BD, Keenan
KM. Comparison of inferior dental nerve block
injections in child patients using 30-gauge
and 25-gauge short needles. Anesth Prog
1987;34(6):215-9.
NEEDLE BREAKAGE DURING DENTAL ANESTHESIA IN THE MAXILLA: REPORT OF A CASE AND LITERATURE REVIEW
Year 2017,
Volume: 3 Issue: 1, 27 - 33, 01.04.2017
Gökhan Gürler
Çağrı Delilbaşı
İpek Kaçar
Abstract
Needle breakage is an uncommon complication during dental anesthesia. It generally occurs in inferior alveolar nerve block; however rare cases during maxillary injections have also been reported. There are different causative factors for needle breakage most of which can be preventable. Advanced radiological techniques are helpful to detect the exact localization of the broken fragment. Surgical removal of the needle is recommended since the broken piece may move deeper through the tissues. Here we report a case of a broken needle during maxillary dental anesthesia as well as radiological features and surgical treatment. Furthermore, we aimed to review the current literature regarding needle breakage during dental anesthesia
References
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Baur DA, Quereshy FA, Teich ST, Gonzalez
AE. Transcervical migration of a broken
dental needle: a case report and literature
review. Oral Surg Oral Med Oral Pathol Oral
Radiol. 2014;118(6):e161-5.
- [2] Augello M, von Jackowski J, Grätz KW,
Jacobsen C. Needle breakage during
local anesthesia in the oral cavity--a
retrospective of the last 50 years with
guidelines for treatment and prevention.
Clin Oral Investig 2011;15(1):3-8.
- [3] Stein KM. Use of Intraoperative Navigation
for Minimally Invasive Retrieval of a
Broken Dental Needle. J Oral Maxillofac
Surg 2015;73(10):1911-6.
- [4] Marks RB, Carlton DM, McDonald S.
Management of a broken needle in the
pterygomandibular space: report of case.
J Am Dent Assoc 1984;109(2):263-4.
- [5] Bhatia S, Bounds G. A broken needle in the
pterygomandibular space: report of a case
and review of the literature. Dent Update
1998;25(1):35-7.
- [6] Kronman JH, el-Bermani AW, Wongwatana
S, Kumar A. Preferred needle lengths
for inferior alveolar anesthesia. Gen Dent
1994;42(1):74-6
- [7] Bailey E, Rao J, Saksena A. Case Report:
Fractured Needle in the Pterygomandibular
Space Following Administration of
an Inferior Dental Nerve Block. Dent Update
2015;42(3):270-2.
- [8] Malamed SF. Handbook of Local Anaesthesia
6th ed. St. Louis, MO. Mosby: 2012.
- [9] Zeltser R, Cohen C, Casap N. The
implications of a broken needle in the
pterygomandibular space: clinical
guidelines for prevention and retrieval.
Pediatr Dent 2002;24(2):153-6.
- [10] Malamed SF, Reed K, Poorsattar S. Needle
breakage: incidence and prevention. Dent
Clin North Am 2010;54(4):745-56
- [11] Catelani C1, Valente A, Rossi A, Bertolai
R. Broken anesthetic needle in the
pterygomandibular space. Four case reports.
Minerva Stomatol 2013;62(11-12):455-63.
- [12] Baart JA, van Amerongen WE, de Jong KJ,
Allard RH. [Needle breakage during
mandibular block anaesthesia: prevention
and retrieval]. Ned Tijdschr Tandheelkd.
2006;113(12):520-3.
- [13] Siessegger M, Mischkowski RA, Schneider
BT, Krug B, Klesper B, Zöller JE. Image
guided surgical navigation for removal
of foreign bodies in the head and neck.
J Craniomaxillofac Surg 2001;29(6):321-5.
- [14] Brucoli M, Deandreis M, Arcuri F, Benech
A. Management of a needle breakage
during third molar extraction with C-ARM
digital fluoroscope. J Craniofac Surg.
201;23(5):1583-4.
- [15] Bacci C, Mariuzzi ML, Ghirotto C, Fusetti
S. Local anesthesia needle breakage in a
5-year-old child during inferior alveolar
nerve block with the Vazirani-Akinosi
technique. Minerva Stomatol.
2012;61(7-8):337-40.
- [16] Gerbino G1, Zavattero E, Berrone M,
Berrone S. Management of needle breakage
using intraoperative navigation following
inferior alveolar nerve block. J Oral
Maxillofac Surg. 2013;71(11):1819-24.
- [17] Hoffmann J, Troitzsch D, Westendorff C,
et al: Temporary intermaxillary fixation using
individualized acrylic splints permits imagedata-based
surgery of the lower jaw and
oropharynx. Laryngoscope 114:1506, 2004
- [18] Gonul E, Akboru M, Timurkaynak E: Orbital
foreign bodies after penetrating gunshot
wounds: Retrospective analysis of 22 cases
and clinical review. Minim Invasive
Neurosurg 42:207, 1999
- [19] Enislidis G, Wagner A, Ploder O, et
al: Computed intraoperative navigation
guidance: A preliminary report on new
technique. Br J Oral Maxillofac Surg
35:271, 1997
- [20] Rifkind JB. Management of a broken needle
in the pterygomandibular space following
a Vazirani-Akinosi block: case report.
J Can Dent Assoc. 2011;77:64.
- [21] Moore UJ, Fanibunda K, Gross MJ. The
use of a metal detector for localisation
of a metallic foreign body in the floor
of the mouth. Br J Oral Maxillofac Surg
1993;31(3):191-2.
- [22] Johansson B, Krekmanov L. Fragment
of broken instrument removed from
field of operation by an electromagnet.
Br J Oral Maxillofac Surg 1987;25(3):265-6.
- [23] Chittenden HB, Chandra A, Sandy CJ. Use
of an electromagnet to retrieve a
broken fascia needle during frontalis
sling surgery. Ophthal Plast Reconstr Surg
2005;21(6):469-70.
- [24] Bump RL, Roche WC. A broken needle
in the pterygomandibular space. Report of a
case. Oral Surg Oral Med Oral Pathol
1973;36(5):750-2.
- [25] Bedrock RD, Skigen A, Dolwick
MF. Retrieval of a broken needle in the
pterygomandibular space. J Am Dent Assoc
1999;130(5):685-7.
- [26] Ho KH. A simple technique for localizing
a broken dental needle in the
pterygomandibular region. Aust Dent
J 1988;33(4):308-9.
- [27] Crouse VL. Migration of a broken anesthetic
needle: report of a case. S C Dent J
1970;28(9):16-9.
- [28] Amies A.B. Broken needles Aust J Dent
1951;55403–406.
- [29] Fraser-Moodie W. Location and localisation
of metal in the tissues Br J Oral Surg
1966; 499–105
- [30] Thompson M, Wright S, Cheng LH, Starr D.
Locating broken dental needles. Int J Oral
Maxillofac Surg 2003;32(6):642-4.
- [31] Ethunandan M, Tran AL, Anand R, Bowden
J, Seal MT, Brennan PA. Needle breakage
following inferior alveolar nerve block:
implications and management. Br Dent J
2007 14;202(7):395-7.
- [32] Nezafati S, Shahi S Removal of broken
dental needle using mobile digital C-arm.
J Oral Sci 2008;50(3):351-3.
- [33] Faura-Solé M, Sánchez-Garcés MA,
Berini-Aytes L, Gay-Escoda C.
Broken anesthetic injection needles: report
of 5 cases. Quintessence Int 1999l;30(7):461-5.
- [34] Kronman JH, el-Bermani AW, Wongwatana
S, Kumar A. Preferred needle lengths for
inferior alveolar anesthesia. Gen Dent
1994;42(1):74-6.
- [35] Philbert R, Hamilton B, Zola M. Management
of needle breakage using intraoperative
navigation following inferior nerve block.
J Oral Maxillofac Surg 2014;72(4):653.
- [36] Brownbill JW, Walker PO, Bourcy BD, Keenan
KM. Comparison of inferior dental nerve block
injections in child patients using 30-gauge
and 25-gauge short needles. Anesth Prog
1987;34(6):215-9.