The Prognosis of Altered Sensation after Extrusion of Root Canal Filling Materials: A Systematic Review of the Literature

J Endod. 2016 Jun;42(6):873-9. doi: 10.1016/j.joen.2016.03.018. Epub 2016 Apr 28.


Introduction: The aim of this study was to systematically review and evaluate the literature regarding the prognosis of altered sensation after extrusion of root canal filling materials and the possible factors influencing it.

Methods: A systematic search of the literature was performed to identify studies that reported on altered sensation after extrusion of root canal filling materials during endodontic treatments. The articles were evaluated for their relevance based on strict inclusion criteria, and the identified suitable articles were subject to data extraction and analysis.

Results: Initially, 109 possibly relevant articles were identified. After screening and full-text evaluations, 28 articles that met the inclusion criteria were analyzed, reporting on a total of 84 patients with altered sensation after extrusion of root canal filling materials. All the included studies, except 1 case series, were case reports. Under the limited available data, the extracted data showed that 91% of the patients had fully or partially recovered over time. Most of the cases in the lower molars as well as most of the cases in which the obturation was performed using paraformaldehyde-containing sealer or cases in which an immediate treatment was not performed did not fully recover.

Conclusions: The current scientific knowledge regarding the prognosis of nerve injuries caused by overextruded endodontic materials relies primarily on case reports. Within the limitations of the published data, it seems that the tooth locations, types of extruded materials and the obturation technique, and treatment after the injury may affect the nerve injury prognosis.

Keywords: Altered sensation; nerve injury; root canal filling materials; root canal treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Dental Materials
  • Epoxy Resins / adverse effects
  • Formaldehyde / adverse effects
  • Formaldehyde / therapeutic use
  • Humans
  • Mandibular Nerve / drug effects
  • Molar
  • Orthodontic Extrusion / adverse effects*
  • Polymers / adverse effects
  • Polymers / therapeutic use
  • Prognosis
  • Resin Cements
  • Root Canal Filling Materials / adverse effects*
  • Root Canal Obturation / adverse effects*
  • Root Canal Obturation / methods
  • Root Canal Preparation / adverse effects
  • Sensation*
  • Trigeminal Nerve Injuries / etiology


  • Dental Materials
  • Epoxy Resins
  • Polymers
  • Reliance resin cement
  • Resin Cements
  • Root Canal Filling Materials
  • epoxy resin-based root canal sealer
  • Formaldehyde
  • paraform