A Case Report of Sensory Disturbance of the Inferior Alveolar Nerve Caused by Root Canal Filling Material (calcium Hydroxide-added Idoform: Vitapex®) Leaked into the Mandibular Canal

Vitapex® is known to promote healing of periapical scars and facilitate skeletogenesis. It is used in routine clinical practice as a root canal filling material after pulpectomy or for the treatment of infected root canals. We report a clinical case of overfilling of Vitapex® from the apical foramen into the mandibular canal that caused inferior alveolar nerve hypoesthesia.A woman in her twenties presented at a local dental clinic for treatment of an infected root canal of the left mandibular second molar and received a Vitapex® injection. After the treatment, she presented with sensory disturbance in her left lower lip and mental region. She was introduced to our department 1 week later. She was diagnosed with sensory disturbance in the left lower lip and side of the chin. A panorama X-ray radiograph revealed a radiopaque image suspected to represent a large overfilling of Vitapex® into the left mandibular canal. After extraction of the left mandibular second molar, the socket was opened. A vitamin B12 formulation was then administered to her, and a series of stellate ganglion blocks was performed. Three months after extraction, radiographic findings revealed that the radiopaque image in the mandibular canal had disappeared, and the sensory disturbance had mostly subsided 4 months after treatment initiation.