The diagnosis and management of nerve injury during endodontic treatment

Background: Nerve injury and an ensuing altered sensation following endodontic treatment is an infrequent and severe complication, which may lead to longstanding disability and may have substantial adverse effects on the patient’s quality of life. This review is aimed at providing the practitioner with the knowledge and useful means to diagnose and manage nerve injury when performing endodontic treatments. Conclusion: Vigorous preventive measures and a timely mannered management approach are the most proficient measures to reduce the risk of endodontic treatment related nerve injuries and to prevent long-lasting impairment. The diagnosis of a nerve injury requires a combination of a thorough anamnesis, a proper clinical evaluation, and an adjunct radiographic evaluation when indicated. Early intervention by the prescription of anti-inflammatory drugs may be beneficial. In certain persistent cases, modern endodontic surgery may enable a minimally invasive and highly accurate surgical procedure, and with adequate case selection, may provide a predictable outcome and allow the preservation of the tooth.