Paresthesia after RCT (Ilya Mer)

Patient was sent to my office with spontaneous pain caused by #36 The restorative treatment was done 18 months before and dentist told the patient that he was going to try to save the tooth and probably did direct pulp cupping. As you see now the restoration quality leaves much to be desired and there was a lot of decay under broken margins. The coronal and radicular pulp bled and in spite of the fact that I finished the shaping at the same visit I decided to leave some calcium hydroxide for a week. The patient was in touch with me several days after the treatment and told that he suffered from pain for two first days then he felt “anesthesia on his lower lip”. Sounded very strange, didn’t’ it? So anesthesia gone after the treatment and came again 3 days after the treatment. I checked him and definitely he had some parasthesia on the left mandibular innervation zone. I refreshed the calcium hydroxide and after 3-4 days the parasthesia was gone. I made the obturation today. I wonder, what the possible mechanism of parasthesia? I can assume the parasthesia can be a consequence of flare up and probable internal swelling that could compress the mandibular nerve. Is it possible? Sounds strange because the mandibular nerve has own lamina dura and requires a lot of forces to be compressed.

PreOp X-ray, area of previous direct pulp capping

PostOp images
6 month recall

There were nither pain, nor parasthesia.

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