--- abstract: 'The mandibular premolars are located close to the mental foramina (Fig. 1). As such, various events affecting these teeth, such as odontogenic infection1 and orthodontic, endodontic, periodontal or surgical misadventure, may result in neurosensory disturbance of the mental nerves.2-4 In one retrospective study, the incidence of mental paresthesia resulting from periapical infection or pathology was 0.96. In another 0.24 of cases in the same study, mental paresthesia was a complication of root canal treatment (caused by severe overfill in one case and iatrogenic perforation of mechanical instrumentation through the root and into the mental nerve in the second case).1 The incidence of mental paresthesia resulting from orthodontic, periodontal and surgical misadventure cannot be determined but is presumably low, as most such cases have been reported as individual case reports. In endodontology, elimination of infection from the pulp and dentin followed by adequate intracanal preparation and proper sealing constitute the basic principles of root canal treatment. Ideally, mechanical preparation and filling should be limited to the root canal, as overinstrumentation or extrusion of chemical fillings beyond the apical foramen to the adjacent nerve may give rise to neurosensory disturbances such as anesthesia, paresthesia or dysesthesia.5 Unfortunately, cases of endodontic extrusion of various filling or irrigation agents continue to be reported, despite recent advances in endodontology.' altloc: [] chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: - ngeowy@um.edu.my creators_name: - family: Ngeow given: W.C. honourific: Dr. lineage: '' date: 2010-06-16 date_type: published datestamp: 2012-04-25 13:00:09 department: ~ dir: disk0/00/00/81/91 edit_lock_since: ~ edit_lock_until: 0 edit_lock_user: ~ editors_id: [] editors_name: [] eprint_status: archive eprintid: 8191 fileinfo: application/pdf;http://cogprints.org/8191/1/Is%20there%20a%20safety%20zon%20in%20the%20mandibular%20premolar%20region%20where%20damage%20to%20the%20mental%20nerve%20can%20be%20avoided%20if%20periapical%20extrusion%20occurs.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: ~ item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: Inferior Alveolar Nerve; Paresthesia; Foramen lastmod: 2012-04-25 13:00:09 latitude: ~ longitude: ~ metadata_visibility: show note: 'Times Cited: 0 Ngeow, Wei Cheong' number: ~ pagerange: ~ pubdom: TRUE publication: Journal of the Canadian Dental Association publisher: 'CANADIAN DENTAL ASSOC, 1815 ALTA VISTA DRIVE, OTTAWA, ON K1G 3Y6, CANADA' refereed: TRUE referencetext: "1. Knowles KI, Jergenson MA, Howard JH. Paresthesia associated with endodontic treatment of mandibular premolars. J Endod. 2003;29(11):768-70.\r\n2. Baxmann M. Mental paresthesia and orthodontic treatment. Angle Orthod. 2006;76(3):533-7.\r\n3. Scarano A, Di Carlo F, Quaranta A, Piattelli A. Injury of the inferior alveolar nerve after overfilling of the root canal with endodontic cement: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(1):e56-9.\r\n4. Pogrel MA, Thamby S. The etiology of altered sensation in the inferior alveolar, lingual, and mental nerves as a result of dental treatment. J Calif Dent Assoc. 1999;27(7):531, 534-8.\r\n5. Pogrel MA. Damage to the inferior alveolar nerve as the result of root canal therapy. J Am Dent Assoc. 2007;138(1):65-9.\r\n6. Fishel D, Buchner A, Hershkowith A, Kaffe I. Roentgenologic study of the mental foramen. Oral Surg Oral Med Oral Pathol. 1976;41(5):682-6.\r\n7. Phillips JL, Weller RN, Kulild JC. The mental foramen: 2. Radiographic position in relation to the mandibular second premolar. J Endod. 1992;18(6):271-4.\r\n8. Denio D, Torabinejad M, Bakland LK. Anatomical relationship of the mandibular canal to its surrounding structures in mature mandibles. J Endod. 1992;18(4):161-5." relation_type: [] relation_uri: [] reportno: ~ rev_number: 8 series: ~ source: ~ status_changed: 2012-04-25 13:00:09 subjects: - JOURNALS - OJHAS succeeds: ~ suggestions: "Associate Prof. Dr. Ngeow Wei Cheong @ David Ngeow\r\nDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of\r\nMalaya, 50603 Kuala Lumpur, MALAYSIA\r\n\r\nAssociate Professor Dr. Ngeow Wei Cheong is currently a lecturer at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry of the University of Malaya. He graduated from the University of Malaya in 1992 and was a private practitioner for 9 months before he was offered the post of tutorship at his alma matter. Three years later, he went to do a house job at the Queen Victoria Hospital in East Grinstead, England. He obtained his Fellowship in Dental Surgery from the Royal College of Surgeons in Ireland and the Royal College of Surgeons ofEngland in 1996. He subsequently returned to Malaysia and was a pioneer lecturer at the then newly established Universiti Kebangsaan Malaysia. He left for private practice in 1999 but the temptation to return to academic life was greater, hence he returned to the University of Malaya the subsequent year. His research interest are craniofacial anthropometry, variations of the mandibular nerve, and recovery of peripheral nerves after microsurgical repair. \r\n \r\n\r\nAREAS OF EXPERTISE\r\n\t\r\nDentofacial Anthropometry (Head & Neck, anthropology)\r\n\r\nDental Analgesics (analgesic, local anaesthetic, COX-2 inhibitors)\r\n\r\nSurgical Anatomy (mental foramen, anterior loop)" sword_depositor: ~ sword_slug: ~ thesistype: ~ title: Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs? type: journalp userid: 16514 volume: 76