{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:26:49Z","timestamp":1780648009628,"version":"3.54.1"},"reference-count":18,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Needle fracture during dental local anesthetic injections is a rare but significant, potentially serious complication. Various approaches for the location and removal of broken needles have been described; however, there are several difficulties and concerns related to the potential complications and critical anatomic challenges peculiar to the head and neck region. In this case, we describe the diagnostic approaches utilized in locating a broken needle that migrated in the pterygomandibular space following gag reflex, and sudden head movement of a middle-aged male patient. A meticulous diagnostic approach was employed to locate the needle utilizing CBCT scan, CT scan with contrast, and C-arm X-ray machine. The needle was successfully retrieved using an angled hemostat inserted through an oral incision, guided by a C-arm X-ray machine and ENT endoscopic instruments. While careful planning could prevent many complications that may arise during oral surgical procedures, inadvertent events leading to serious complications should be addressed using the appropriate and timely diagnostic techniques pre-and intra-operatively.<\/jats:p>","DOI":"10.3390\/diagnostics13193050","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T02:31:29Z","timestamp":1695695489000},"page":"3050","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management"],"prefix":"10.3390","volume":"13","author":[{"given":"Ziad","family":"Malkawi","sequence":"first","affiliation":[{"name":"School of Dentistry, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Alayeh","sequence":"additional","affiliation":[{"name":"School of Dentistry, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abedalaziz","family":"Alshawa","sequence":"additional","affiliation":[{"name":"School of Dentistry, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Shaban","sequence":"additional","affiliation":[{"name":"School of Dentistry, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Al Saraireh","sequence":"additional","affiliation":[{"name":"King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashem","family":"Malkawi","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland Medical University in Bahrain, Manama 15503, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7079-4684","authenticated-orcid":false,"given":"Hamzah","family":"Babkair","sequence":"additional","affiliation":[{"name":"College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-3918","authenticated-orcid":false,"given":"Ismail","family":"Abdouh","sequence":"additional","affiliation":[{"name":"College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najla","family":"Dar-Odeh","sequence":"additional","affiliation":[{"name":"School of Dentistry, The University of Jordan, Amman 11942, Jordan"},{"name":"College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00784-010-0442-6","article-title":"Needle breakage during local anesthesia in the oral cavity-a retrospective of the last 50 years with guidelines for treatment and prevention","volume":"15","author":"Augello","year":"2011","journal-title":"Clin. 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Oral Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2473974X20947026","DOI":"10.1177\/2473974X20947026","article-title":"Endoscopic Transoral Image-Guided Retrieval of Infratemporal Fossa Foreign Bodies","volume":"4","author":"Lehmann","year":"2020","journal-title":"OTO Open."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/19\/3050\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:57:49Z","timestamp":1760129869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/19\/3050"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,25]]},"references-count":18,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["diagnostics13193050"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13193050","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,25]]}}}