The implications of a broken needle in the pterygomandibular space: clinical guidelines for prevention and retrieval

The implication of a broken anesthetic injection needle in the posterior part of the oral cavity is described. Needle breakage is preventable if proper preventive measures are used during local anesthesia administration. A broken needle should be removed immediately after a thorough localization and not left in the tissue, as previously believed. Computerized tomography (CT) scan is the proper diagnostic device to locate a broken needle. A careful surgical approach under general anesthesia is recommended to retrieve the needle. Clinical preventive guidelines are described and presented to the pediatric dentist.