J Dent Anesth Pain Med.  2018 Jun;18(3):177-182. 10.17245/jdapm.2018.18.3.177.

Delayed paresthesia of inferior alveolar nerve after dental surgery: case report and related pathophysiology

  • 1Department of Advanced General Dentistry, School of Dentistry, Dankook University, Cheonan, Korea. bestdenmin@naver.com


Paresthesia is an altered sensation of the skin, manifesting as numbness, partial loss of local sensitivity, burning, or tingling. The inferior alveolar nerve (IAN) is the third branch of the trigeminal nerve and is very important in dental treatment. IAN paresthesia may occur after various dental procedures such as simple anesthetic injections, surgical procedures, and endodontic treatment, and is reported to range from 0.35% to 8.4%. The altered sensation usually follows immediately after the procedure, and reports of late onset of nerve involvement are rare. This report presents a rare case of delayed paresthesia after dental surgery and discusses the pathophysiology of IAN delayed paresthesia.


Delayed Paresthesia; Inferior Alveolar Nerve; Pathophysiology

MeSH Terms

Mandibular Nerve*
Trigeminal Nerve


  • Fig. 1 Preoperative radiographs demonstrating left lower third molar, which was very close to the inferior alveolar canal. (A) Panoramic radiograph, (B) Cone beam computed tomography: panoramic view, (C) Cone beam computed tomography: cross-sectional view.

  • Fig. 2 Two weeks postoperatively (first day of paresthesia), the extraction site showed no swelling or redness of the soft tissue but partial loss of blood clot was observed.

  • Fig. 3 Skin mapping of the affected area outlining abnormal sensation.

  • Fig. 4 Postoperative radiographs demonstrating the discontinuity of upper cortical layer of the inferior alveolar canal. (A) Cone beam computed tomography: panoramic view, (B) Cone beam computed tomography: cross-sectional view.


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