Transient facial nerve paralysis following inferior alveolar and lingual nerve block: Clinical case and management review

Rodrigo Figueiredo de Brito Resende; Jessica Zachar; Gustavo Vicentis Oliveira Fernandes; Marcelo José Pinheiro de Uzeda; Peter Reher; Rodrigo Figueiredo de Brito Resende; Jessica Zachar; Gustavo Vicentis Oliveira Fernandes; Marcelo José Pinheiro de Uzeda; Peter Reher

doi:10.3934/jdms.2026008

Journal of Dentistry and Multidisciplinary Sciences

2026, Volume 2, Issue 1: 62-69. doi: 10.3934/jdms.2026008

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Case report

Transient facial nerve paralysis following inferior alveolar and lingual nerve block: Clinical case and management review

Rodrigo Figueiredo de Brito Resende ^1,2,3,
Jessica Zachar ^3,4,
Gustavo Vicentis Oliveira Fernandes ^{5
,
,},
Marcelo José Pinheiro de Uzeda ^1,2,
Peter Reher ³

1.
School of Dentistry, Iguaçu University, Nova Iguaçu, RJ, Brazil
2.
School of Dentistry, Federal Fluminense University, Niterói, RJ, Brazil
3.
School of Dentistry, The University of Queensland, Brisbane, QLD, Australia
4.
Oral Health Alliance, STARS, Metro North Health, Qld Health, QLD, Australia
5.
Periodontics, Bitonte College of Dentistry, Northeast Ohio Medical University (NEOMED), Rootstown, Ohio, USA

Received: 16 April 2026 Revised: 11 June 2026 Accepted: 07 July 2026 Published: 15 September 2026

Transient facial nerve paralysis (TFNP) is an uncommon but clinically significant complication associated with mandibular nerve blocks, typically resulting from the inadvertent diffusion of anesthetic solution into the parotid gland. This report presents the case of a 49-year-old female patient who underwent extraction of the lower left second molar under local anesthesia with 4% articaine and 1:100,000 epinephrine, subsequently developing immediate unilateral facial paralysis with full recovery within six hours. The likely etiology was posterior needle insertion and anesthetic deposition in the parotid region. This case emphasizes the importance of technical precision in identifying bony landmarks, anatomical knowledge, and proper execution of the inferior alveolar nerve block to prevent transient neurological complications.
- transient facial nerve paralysis,
- local anesthesia,
- dentistry,
- anesthesiology
Citation: Rodrigo Figueiredo de Brito Resende, Jessica Zachar, Gustavo Vicentis Oliveira Fernandes, Marcelo José Pinheiro de Uzeda, Peter Reher. Transient facial nerve paralysis following inferior alveolar and lingual nerve block: Clinical case and management review[J]. Journal of Dentistry and Multidisciplinary Sciences, 2026, 2(1): 62-69. doi: 10.3934/jdms.2026008

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Abstract

Transient facial nerve paralysis (TFNP) is an uncommon but clinically significant complication associated with mandibular nerve blocks, typically resulting from the inadvertent diffusion of anesthetic solution into the parotid gland. This report presents the case of a 49-year-old female patient who underwent extraction of the lower left second molar under local anesthesia with 4% articaine and 1:100,000 epinephrine, subsequently developing immediate unilateral facial paralysis with full recovery within six hours. The likely etiology was posterior needle insertion and anesthetic deposition in the parotid region. This case emphasizes the importance of technical precision in identifying bony landmarks, anatomical knowledge, and proper execution of the inferior alveolar nerve block to prevent transient neurological complications.

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