Needle fracture as a complication of dental local anesthesia: recommendations for prevention and a comprehensive treatment algorithm based on literature from the past four decades

被引：21

作者：

Acham, Stephan ^{[1
]}

Truschnegg, Astrid ^{[1
]}

Rugani, Petra ^{[1
]}

Kirnbauer, Barbara ^{[1
]}

Reinbacher, Knut Ernst ^{[2
]}

Zemann, Wolfgang ^{[3
]}

Kqiku, Lumnije ^{[4
]}

Jakse, Norbert ^{[1
,3
]}

机构：

[1] Med Univ Graz, Dept Dent Med & Oral Hlth, Div Oral Surg & Orthodont, Billrothgasse 4, A-8010 Graz, Austria

[2] Off Maxillofacial Surg & Dent Med, Ringweg 98530, A-8530 Deutschlandsberg, Austria

[3] Med Univ Graz, Div Oral & Craniomaxillofacial Surg, Auenbruggerpl 5, A-8036 Graz, Austria

[4] Med Univ Graz, Dept Dent Med & Oral Hlth, Div Prevent & Operat Dent, Endodont Periodontol Prosthodont Restorat Dent &, Billrothgasse 4, A-8010 Graz, Austria

来源：

CLINICAL ORAL INVESTIGATIONS | 2019年 / 23卷 / 03期

关键词：

Hypodermic needle; Needle breakage; Dental anesthesia; Local anesthesia; Complication; Foreign body removal; BROKEN NEEDLE; BREAKAGE; MANAGEMENT; MIGRATION; SPACE;

D O I：

10.1007/s00784-018-2525-8

中图分类号：

R78 [口腔科学];

学科分类号：

1003 ;

摘要：

ObjectivesThe aim of this publication is to provide a concept for prevention and a standardized step-by-step clinical approach to this rare but serious and potentially preventable complication of dental local anesthesia.Materials and methodsWe collected data with a PUBMED search using the key words local anesthesia, dental anesthesia/anesthesia OR mandibular block anesthesia, complication, hypodermic needle, needle breakage OR needle fracture, and foreign body AND removal OR retrieval. The existing literature was systematically evaluated from 1980 to date using Microsoft Excel 2007 (Microsoft Corporation).ResultsAfter analysis of the literature, we included 36 reports documenting 59 needle breakage events and defined possible risk factors and preventive measures. All relevant reported parameters were listed in tabular form. The main result of this article is a treatment algorithm for this complication.ConclusionsPrevention of a needle fracture should be the main goal during local dental anesthesia. Use of longer hypodermic needle can obviate complex retrieval surgery. If immediate removal of the fragment fails, localization, planning, and the necessary surgical procedure should be arranged promptly.Clinical relevanceFollowing a strict algorithm, successful surgical handling of this complication will depend on minimizing risk and following treatment recommendations closely.

引用

页码：1109 / 1119

页数：11

共 57 条

[1]

Acham S., 2014, QUINTESSENZ, V65, P1385

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