Diagnosis and Management of Mental Nerve Paresthesia Secondary to Apical Periodontitis of Mandibular Second Premolar: A CBCT Based Case Report

Authors: Aneja J , Nangia D* , Vats P and Bhasin P

DOI: 10.23880/oajds-16000418

Volume 11, Issue 2

Abstract

Mental nerve paraesthesia of odontogenic origin is rare and its etiology may be misdiagnosed during initial evaluation. The present case report describes a 37-year-old female presenting with persistent numbness and tingling of the left lower lip and chin, with no improvement in symptoms despite medical consultation. Neurosensory assessment revealed complete sensory deficit (S0) of the said dermatome. Clinical examination revealed deep caries in left mandibular second premolar (#20), and its radiographic findings disclosed a periapical radiolucency. 3-Dimensional imaging using cone-beam computed tomography (CBCT) was conducted to confirm the etiological relationship of periapical radiolucency in #20 with the mental nerve. Non-surgical endodontic treatment (NSET) was performed, resulting in progressive neurosensory recovery from S0 to S4 over eight weeks. This case highlights the critical importance of accurate diagnosis in patients presenting with unexplained paraesthesia and underscores the value of CBCT in delineating the relationship between periapical pathology and adjacent neural structures. NSET can effectively eliminate the etiology in such cases, aiding in complete neurosensory recovery without the need for any surgical intervention.

Keywords: Paresthesia; Mental Nerve; Apical Periodontitis; Endodontic Therapy; Cone Beam Computed Tomography

View PDF