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Broken needle: a rare complication of inferior alveolar nerve block - a report of two cases

British Dental Journal volume 233, pages 621–624 (2022)Cite this article

Abstract

Introduction Needle fracture during the delivery of local anaesthesia is a rare complication in modern dentistry. While there has been a decline in its occurrence with the advent of disposable flexible alloys, it still occurs and it is important for all clinicians to know how to deal with this complication. The management of a lost needle in the pterygomandibular space when giving an inferior alveolar nerve block has proven a dilemma in the past. In this paper, we discuss how to minimise the risk and the relevant management of such a scenario while examining two cases of needle fracture while delivering an inferior alveolar nerve block.

Discussion There are a number of structures present in the pterygomandibular space of which all clinicians should be cognisant. Should a needle fracture and cannot be removed immediately by the clinician, prompt maxillofacial referral is required for further management.

Conclusion While rare, needle fracture can occur while delivering an inferior alveolar nerve block and all clinicians should be aware of how to minimise the risk and how to manage such a complication. If it cannot be removed at the time, a prompt maxillofacial referral should be made.

Key points

  • Outlines the risks associated with the fracture of a needle while delivering an inferior alveolar nerve block.

  • Describes methods to reduce such a complication from occurring.

  • Advises how to manage such a complication when it occurs.

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Authors and Affiliations

  1. National Maxillofacial Unit, St James´ Hospital, Dublin, Ireland

    Daniel Dilworth, Harriet Byrne & Gerard Kearns

Authors
  1. Daniel Dilworth
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  2. Harriet Byrne
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  3. Gerard Kearns
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Contributions

Daniel Dilworth and Harriet Byrne reviewed the patient records and produced the first draft of the manuscript. Gerard Kearns treated the patients and edited the final submitted manuscript.

Corresponding author

Correspondence to Gerard Kearns.

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The authors declare that they have no conflicts of interest.

Written informed consent for publication was obtained from all patients whose details and images were used in this article.

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Dilworth, D., Byrne, H. & Kearns, G. Broken needle: a rare complication of inferior alveolar nerve block - a report of two cases. Br Dent J 233, 621–624 (2022). https://doi.org/10.1038/s41415-022-5081-1

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