Dental diplopia with transient abducens palsy

Abstract

Diplopia is uncommon after intraoral local anesthesia for dental procedures.1–7⇓⇓⇓⇓⇓⇓ A healthy 29-year-old man was examined at a hospital-based dental clinic several days after sustaining mild facial trauma during a snow skiing accident. He had dental pain and thermal sensitivity, which related to fractured cusps of the bottom right second premolar tooth (no. 29). Because of the severity of the cusp fracture, the treatment plan was to remove this tooth. The patient’s medical history was otherwise unremarkable, and he denied any allergies. The dentist proceeded to anesthetize the patient with a right inferior alveolar nerve block using a standard 25-gauge needle (1.5 inches) and 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. No other anesthetic or analgesic was used during this procedure. Initial aspiration …