Dental broken needle migration to the skull base: a case of dental broken needle migration to the skull base: anatomical considerations and prevention

Introduction: the needle fracture during the inferior alveolar nerve block is not a common accident, but whenit occurs can cause great inconvenience to the professional and patient, because the surgical removal shouldonly be performed without risk of sequelae to the patient. Aim: relate a case of broken dental needle duringinferior alveolar nerve block and the needle fragment dislocation to the skull base becoming impossible itssurgical removal. Described preventive procedures to avoid that complication with anatomical considerationsrelated to the inferior alveolar nerve block. Case report: a young female, 18 years old required care afterfracture of the dental needle during inferior alveolar nerve anesthesia. She was submitted to CT scan thatdetermined the impossibility of surgical removal of the fragment because it has migrated to the skull basebecoming close to vital anatomic structures because its could produce irreparable sequelae such loss of tonguesensation and movement of the lip. A conservative treatment was offered. Conclusions: surgical removal ofits instrument should be correctly evaluated to avoided irreparable sequelae to the patient. The knowledgeof anatomical structures in the pterigomandibular region may reduce the risk of injury to nerves and anotherstructures and prevent further complications.

The frontal sinus morphology in radiographs of Brazilian subjects: its forensic importance

The determination of gender of unknown persons is of vital importance in forensic investigations, such as anthropologic,medical and dental forensic studies, mainly in cases where only fragments of the skull remain and there is no possibility of identification based on the dental arch. The aim of the present study was to develop a mathematical method based on logistic regression analysis capable of determining the gender of individuals using measurements of the frontal sinus. The right and left areas and the maximum height and width of the frontal sinus were determined in 100 radiographs taken by the Caldwell technique of 50 women and 50 men between 20 and 30 years old, with the help of the prog ram SIARCS 3.0 (EMBRAPA). The mean values of the frontal sinus were greater in males and the left area was larger than the right area, based on Student’s t-test at the 5% level of significance. The mathematical model based on logistic regression analysis gave a concordanceindex for gender of 79.7% in the cases studied. The areas of the frontal sinus and the logistic regression technique proved to be useful in the determination of gender. (Logit = 1.6905 – 0.5383* left area).