Abstract:
Paresthesia is a potential consequence of unsuccessful root canal treatment. Persistent
infection resulting in apical periodontitis may enlarge sufficiently to involve the mental
neurovascular bundle. The case presented in this report was referred for endodontic
evaluation with a chief complaint of discomfort on mastication and persistent numbness of the
lower left lip. Clinical and radiographic evaluation revealed incomplete primary endodontic
treatment of the left mandibular second premolar with complex internal anatomy. The
untreated root canal system resulted in the progression of apical periodontitis involving the left
mental neurovascular bundle as confirmed by cone-beam computed tomography imaging.
Nonsurgical root canal retreatment was performed over 2 visits. At the 3-year follow-up visit,
the paresthesia had resolved with return of normal sensation. Nonsurgical endodontic
retreatment may be sufficient to allow healing of large periapical lesions and resolve
complications including paresthesia without the need for surgical intervention.
