Diagnosis of paresthesia or neural anesthesia is based on a complete medical history, with assessment from the onset of symptoms.6 Reactions of the affected area to thermal stimuli, mechanical action, and electrical or chemical tests also contribute to the diagnosis, although these responses are subjective. Periapical radiographs are essential to establishing the relationship between the dental apex and certain nerve endings, especially in the mandible (Fig. 3). De Beukelaer and colleagues30 reported the use of sensitivity tests to detect the extent and severity of paresthesia. Mechanical, thermal and taste tests were carried out at regular intervals, revealing the progress of treatment. According to these authors, clinical examination of patients who report a lesion of the lingual nerve should begin with observation of nerve function, specifically pronunciation and swallowing. Palpation of the sensitized region should also be performed. Two types of clinical neurosensitivity testing can be performed, according to the specific receptors that are stimulated through skin contact: mechanoceptive and nociceptive. Mechanoceptive testing is based on a light static touch and the directional brush stroke test, whereas nociceptive testing is based on observation of thermal sensation experienced when specific groups of sensory nerve fibres are stimulated, in addition to the touch sensation evoked by sharp instruments. Paresthesia caused by filling beyond the apex and subsequent compression of the inferior alveolar neurovascular set has been described in the literature.10,12 However, given that the majority of endodontic materials have some chemical action in cases of extravasation, it is difficult to determine whether the nature of the effect on the nerve is mechanical, through compression of the structure, or chemical, caused by cytotoxicity of the

Diagnosis paresthesia atau anestesi saraf adalah Berdasarkan riwayat kesehatan lengkap, dengan penilaian sejak timbulnya gejala Reaksi area yang terkena rangsangan termal, mekanis tindakan, dan tes listrik atau kimia juga berkontribusi pada diagnosis, meskipun respons ini bersifat subjektif. Radiografi periapikal sangat penting untuk membangun hubungan antara gigi puncak dan ujung saraf tertentu, terutama di rahang bawah (Gbr. 3). De Beukelaer dan rekan30 melaporkan penggunaan tes sensitivitas untuk mendeteksi luas dan keparahan paresthesia. Mekanis, termal dan tes rasa dilakukan secara berkala, mengungkapkan kemajuan pengobatan. Berdasarkan penulis ini, pemeriksaan klinis pasien yang melaporkan lesi pada saraf lingual harus dimulai dengan observasi fungsi saraf, khususnya pengucapan dan menelan. Palpasi daerah peka juga harus dilakukan. Dua jenis pengujian neurosensitivitas klinis dapat dilakukan, sesuai dengan reseptor spesifik yang dirangsang melalui kontak kulit: mekanik dan nosiseptif.Mekanoseptif pengujian didasarkan pada sentuhan statis ringan dan tes sapuan kuas terarah, sedangkan nosiseptif pengujian didasarkan pada pengamatan sensasi termal yang dialami ketika kelompok serabut saraf sensorik tertentu dirangsang, selain dari sensasi sentuhan yang ditimbulkan oleh instrumen tajam. Paresthesia yang disebabkan oleh pengisian di luar puncak dan kompresi selanjutnya dari set neurovaskular alveolar inferior telah dijelaskan di literatur.10,12 Namun, mengingat mayoritas bahan endodontik memiliki beberapa aksi kimiawi dalam kasus ekstravasasi, sulit untuk menentukan apakah sifat efeknya pada saraf bersifat mekanis, melalui kompresi struktur, atau kimiawi, yang disebabkan oleh sitotoksisitas