Fluoroscopy for intraoral removal of fractured needle

Abstract

There are few reports in the literature concerning needle fractures during the local administration of anesthetic solution in dental procedures. However, the risk still exists. The patient’s unexpected movement during anesthesia, bending the needle prior to its use in the tissue, incorrectly performed anesthetic technique, uncooperative patient, small needle diameter or size may be considered substantial risks of fracture. At the moment the needle fracture occurs in the tissues it can move to the patient’s vital regions, and it is of utmost importance to remove it. If it is not possible to remove the needle immediately, an oral surgeon should be contacted to remove it under general anesthesia at the hospital. This paper aims to report a case of needle fracture in third molar exodontia during lower alveolar, lingual and buccal right nerve block, referred to the oral and maxillofacial surgery and traumatology department of the State University of Maringá. After clinical examination and tomography assessment, the patient underwent a surgical procedure to remove the needle in the operating room under general anesthesia and aid of trans-operative fluoroscopy. Therefore, we conclude that fluoroscopy is an extremely important resource in cases such as this one, since it allows a guided procedure, reducing the surgical trauma of an exploratory surgery.