case_images: PMC11808329_01
case_images: A) The skin in the region of the left mental nerve distribution presented with parestesia; B) CBCT images of the initial appointment
case_images: IEJ-20-e5-g001.jpg
case_images: PMC11808329_01_IEJ-20-e5-g001.jpg
case_images: F1
case_images: Mapping the injury area: The skin and chin area of the lower left lip without response to sensory testing was mapped and recorded using a ballpoint pen on the patient's face (Figure 1A).  Two-point discrimination test : The patient was unable to discriminate a single pressure point (Figure 1A). Max, Planmeca OY, Helsingfors, Finland) (74 kV, 10 mA (8x8x8), which confirmed the close proximity (1.40 mm) between the mental canal foramen and the apex of the second left mandibular premolar (Figure 1B). Mental nerve paresthesia was decided as the diagnosis and diclofenac sodium, thiamine, cyanocobalamin, and pyridoxine (Dolo-Neurobion Forte) were prescribed for 7 days as part of the treatment.
case_images: Root canal treatment of the mandibular left second premolar; A) A) Initial radiograph and K-file #10 broke; B) Conductometry (working length determination); C) Conometry (master cone confirmation); D) Obturation
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case_images: PMC11808329_01_IEJ-20-e5-g002.jpg
case_images: F2
case_images: Paul, MN, USA) as a final restoration (Figures 2A-D).
case_images: The skin in the region of the left mental nerve distribution presented with parestesia; A) 1-month control; B) 3-month control; C) 6-month control
case_images: IEJ-20-e5-g003.jpg
case_images: PMC11808329_01_IEJ-20-e5-g003.jpg
case_images: F3
case_images: After the first month the tooth had become asymptomatic, the feeling of paresthesia was still present, and the patient was experiencing a painful electric shock sensation (Figure 3A). After 3 months, the feeling of numbness was reduced, and the patient confirmed the continuation of consuming vitamin B12 (Figure 3B). After 6 months, remarkable improvement was observed and the area affected by paresthesia was significantly reduced, but a slight electric shock sensation was still present (Figure 3C).
case_images: CBCT images after 8 months follow-up, tomography demostrated bone healing around the apex of the second premolar
case_images: IEJ-20-e5-g004.jpg
case_images: PMC11808329_01_IEJ-20-e5-g004.jpg
case_images: F4
case_images: Periapical radiography and CBCT scan showed that periapical radiolucency had disappeared, with adequate hard tissue formation between the apex and the mental foramen (Figure 4).