Delayed onset peripheral facial nerve palsy after dental extraction: a case report and literature review.

This article focuses on a rare case of delayed onset peripheral facial nerve palsy (PFP) following dental extraction and local intraoral anesthesia. It presents a 30-year-old woman who developed right-sided PFP five days after receiving a 4% articaine anesthetic for molar extraction, with clinical, electromyographic, and magnetic resonance imaging evidence of facial nerve denervation and neuritis. The patient was treated with corticosteroids, nonsteroidal anti-inflammatory drugs, vitamin B supplements, and mime therapy, resulting in gradual improvement from House–Brackmann grade IV to grade III over nine months. The report discusses possible etiologies of delayed PFP after dental procedures, including trauma, ischemic neuritis, and viral reactivation similar to Bell's palsy, and emphasizes the importance of early diagnosis, multidisciplinary management, and patient counseling regarding prognosis and potential incomplete recovery.