Extrusion of calcium silicate-based root canal sealers into the inferior alveolar canal: A review of literature
Keywords:
apical extrusion, bioceramic root canal sealers, inferior alveolar canal, inferior alveolar nerve, mandibular canalAbstract
Calcium silicate-based root canal sealers (CSS) have transformed root canal treatment with their excellent properties. However, the risk of extrusion into the inferior alveolar canal (IAC) may lead to nerve injuries and significant morbidity. Multiple factors contribute to extrusion, including anatomical variability, over-aggressive canal preparation, and the high flowability of CSS. Both non-surgical and surgical management strategies are discussed. Non-surgical interventions, including those that employ corticosteroids, B vitamins, and analgesics, show promise in reducing inflammation and supporting nerve recovery. In contrast, surgical techniques, including material removal and nerve decompression, are reserved for severe cases. Early diagnosis through advanced imaging, such as cone-beam computed tomography (CBCT), is crucial for effective intervention. Clinicians should conduct thorough preoperative assessments and refine obturation methods to minimize extrusion risks. Further research and the development of standardized guidelines are necessary to manage sealer extrusion into the IAC, which will enhance endodontic practice and minimize the risk of permanent nerve damage.
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