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Questions and Answers
What is a potential cause of paresthesia according to the text?
What is a potential cause of paresthesia according to the text?
What increases the likelihood of nerve injury during a second division (maxillary) nerve block?
What increases the likelihood of nerve injury during a second division (maxillary) nerve block?
What is mentioned as another potential cause of paresthesia?
What is mentioned as another potential cause of paresthesia?
What is identified as a potential contributor to the development of paresthesia after local anesthetic injection?
What is identified as a potential contributor to the development of paresthesia after local anesthetic injection?
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What is described as a potential cause of an 'electric shock' sensation during injection?
What is described as a potential cause of an 'electric shock' sensation during injection?
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What was the reported incidence of paresthesia for articaine in 2007?
What was the reported incidence of paresthesia for articaine in 2007?
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What percentage of reported paresthesia cases involved the inferior alveolar nerve block (IANB) according to the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS)?
What percentage of reported paresthesia cases involved the inferior alveolar nerve block (IANB) according to the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS)?
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What did the meta-analysis comparing articaine and lidocaine conclude about articaine's anesthetic success rate?
What did the meta-analysis comparing articaine and lidocaine conclude about articaine's anesthetic success rate?
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What did Pogrel conclude about nerve involvement for articaine based on the clinic's figures and assumption about local anesthetics for inferior alveolar nerve blocks?
What did Pogrel conclude about nerve involvement for articaine based on the clinic's figures and assumption about local anesthetics for inferior alveolar nerve blocks?
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What may lead to self-inflicted soft tissue injury in cases of persistent anesthesia?
What may lead to self-inflicted soft tissue injury in cases of persistent anesthesia?
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What percentage of paresthesia cases had pain present according to the text?
What percentage of paresthesia cases had pain present according to the text?
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What was the observed frequency of paresthesia after administration of articaine hydrochloride and prilocaine hydrochloride?
What was the observed frequency of paresthesia after administration of articaine hydrochloride and prilocaine hydrochloride?
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What is the estimated incidence of paresthesia resulting from all local anesthetics?
What is the estimated incidence of paresthesia resulting from all local anesthetics?
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Which local anesthetic was responsible for the highest percentage of reported cases of paresthesia?
Which local anesthetic was responsible for the highest percentage of reported cases of paresthesia?
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What did the review of insurance claims suggest about the use of articaine for inferior alveolar nerve blocks?
What did the review of insurance claims suggest about the use of articaine for inferior alveolar nerve blocks?
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What is the estimated number of patients treated with articaine annually, according to the Pharmacovigilance Working Committee of the European Union?
What is the estimated number of patients treated with articaine annually, according to the Pharmacovigilance Working Committee of the European Union?
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What percentage of reported cases of paresthesia did not match the percentage of market share for any given drug?
What percentage of reported cases of paresthesia did not match the percentage of market share for any given drug?
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What is the primary concern with transient facial nerve paralysis?
What is the primary concern with transient facial nerve paralysis?
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How long does the loss of motor function due to local anesthetic typically last?
How long does the loss of motor function due to local anesthetic typically last?
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What is a potential ocular complication from intraoral injections of local anesthetics?
What is a potential ocular complication from intraoral injections of local anesthetics?
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How can transient facial nerve paralysis be managed?
How can transient facial nerve paralysis be managed?
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What can lead to transient facial nerve paralysis?
What can lead to transient facial nerve paralysis?
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What is the percentage of reviewed cases that reported ocular complications from intraoral dental injections?
What is the percentage of reviewed cases that reported ocular complications from intraoral dental injections?
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What is the recommended treatment for paresthesia after local anesthetic administration?
What is the recommended treatment for paresthesia after local anesthetic administration?
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What is the percentage of patients in very select circumstances who may develop paresthesia after local anesthetic administration?
What is the percentage of patients in very select circumstances who may develop paresthesia after local anesthetic administration?
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When does the text recommend rescheduling the patient for examination if the sensory deficit persists?
When does the text recommend rescheduling the patient for examination if the sensory deficit persists?
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What is the duration range for resolution of paresthesia, as reported in the text?
What is the duration range for resolution of paresthesia, as reported in the text?
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What is the total number of participants who reported paresthesia 4 to 8 days after the procedure, as reported in the text?
What is the total number of participants who reported paresthesia 4 to 8 days after the procedure, as reported in the text?
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What is the most commonly encountered complication after local anesthesia administration, as mentioned in the text?
What is the most commonly encountered complication after local anesthesia administration, as mentioned in the text?
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What percentage of cases reported confirmed resolution of paresthesia?
What percentage of cases reported confirmed resolution of paresthesia?
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What is the recommended treatment for paresthesia resulting from local anesthesia?
What is the recommended treatment for paresthesia resulting from local anesthesia?
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What is the reported range for the resolution of paresthesia?
What is the reported range for the resolution of paresthesia?
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What is the reported incidence of paresthesia 4 to 8 days after the procedure in clinical trials?
What is the reported incidence of paresthesia 4 to 8 days after the procedure in clinical trials?
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What can lead to facial nerve paralysis from local anesthesia?
What can lead to facial nerve paralysis from local anesthesia?
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When should administration of local anesthetic into the affected region be avoided for patients with persistent sensory deficit?
When should administration of local anesthetic into the affected region be avoided for patients with persistent sensory deficit?
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Study Notes
Facial Nerve Paralysis and Ocular Complications from Local Anesthesia in Dentistry
- The facial nerve branches include buccal and mandibular branches, supplying different facial muscles.
- Transient facial nerve paralysis can be caused by local anesthetic introduction into the parotid gland, leading to temporary paralysis.
- Loss of motor function due to local anesthetic is typically short-term, lasting a few hours, with minimal sensory loss.
- The primary issue with transient facial nerve paralysis is cosmetic, causing the face to appear lopsided.
- Transient facial nerve paralysis is preventable by adhering to protocol during nerve blocks, but in some cases, branches of the facial nerve may be close to the injection site.
- Management of transient facial nerve paralysis includes reassuring the patient, applying an eye patch, and recording the incident in the patient's record.
- Ocular complications from intraoral injection of local anesthetics can occur due to diffusion of the anesthetic affecting nerves around the eyes.
- A systematic review reported 89 cases of ocular complications associated with intraoral dental injections, with various complications listed in Table 17.5.
- The diffusing local anesthetic can, on rare occasions, lead to ocular complications due to the proximity of the eyes to the mouth.
- Ocular complications from intraoral injections include blindness, double vision, globe penetration, impaired visual acuity, mydriasis, and others.
- The reported ocular complications were found in 92% of the reviewed cases, emphasizing the potential severity of these issues.
- The study reviewed literature from 1954 to 2013, highlighting the historical prevalence of ocular complications from intraoral dental injections.
Complications of Local Anesthesia in Dentistry
- Paresthesia from inferior alveolar nerve block can lead to permanent nerve involvement in some patients
- Most cases of paresthesia resolve within 8 weeks without treatment, with severe permanent damage occurring rarely
- Resolution of paresthesia ranged from 1 day to 736 days, with 31.4% of cases reporting confirmed resolution
- In clinical trials, 1% of participants experienced paresthesia 4 to 8 days after the procedure, with all cases ultimately resolving
- Management of patients with persistent sensory deficit after local anesthesia involves reassuring the patient and arranging an examination
- Observation is the recommended treatment for paresthesia, with surgical correction having suboptimal results
- Patients should be examined every 2 months as long as the sensory deficit persists
- Dental treatment may continue, but administration of local anesthetic into the affected region should be avoided
- Facial nerve paralysis can occur from an infraorbital nerve block or inadvertent deposition of local anesthetic
- Paralysis affects muscles of facial expression, scalp, and external ear, and can occur when anesthetic is introduced into the deep lobe of the parotid gland
- The facial nerve branches and the muscles they innervate include temporal and zygomatic branches
- Muscle droop and paralysis can occur when motor fibers are anesthetized by local anesthetic deposition
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Description
Test your knowledge of facial nerve paralysis and ocular complications from local anesthesia in dentistry with this quiz. Explore the causes, management, and prevention of transient facial nerve paralysis, as well as the potential ocular complications and their severity. Stay informed about the risks and precautions associated with intraoral injections to ensure patient safety.
