Ipoestesia del nervo mentoniero causata da infezioni odontogene: casi clinici

Abstract

ObjectivesWe describe a case series in which the presence of Numb Chin Syndrome (NCS) was the most relevant symptom related to odontogenic infections and cystic lesions. This neuropathy of the mental nerve is characterized by the presence of hypoesthesia or paresthesia of the lower lip and chin. Materials and methodsWhen not related to iatrogenic causes, the condition is clinically significant because of its frequent association with malignant diseases, especially lymphoma and metastatic lesions. However, several cases have been ascribed to dental pathologies, such as dentoalveolar abscesses or benign tumours. Three cases of NCS are described. A 59-year-old man (case I) presented with violent pain in the right premolar region; after a few days, hypoesthesia of right mental nerve also appeared. Clinical and radiologic examinations confirmed the presence of an osteolytic infective lesion originated from 4.5. A 45-year old-woman (case II) reported a continuous not evoked pain at 3.5, 3.6 and hypoesthesia of left mental nerve; dental panoramic tomography revealed an expanding lytic lesion involving the mandibular canal suggesting a cystic lesion in relation to 3.6. A 63-year-old man (case III) reported a violent pain in the right lower molar and premolar region; hypoesthesia of the right mental nerve soon followed. In the CT imaging, signs of osteitis with sequestrum originated from apical periodontitis of 4.7 and 4.5 were found. Discussion and conclusionsAlthough the mental nerve neuropathy is considered a “red flag” symptom of a distant malignant neoplasm, odontogenic infective causes or benign tumours should be considered.