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Osteomyelitis due to arsenic trioxide use for tooth devitalization
A Dumlu1, S Yalcinkaya, V Olgac
1Department of Oral Diagnosis and Radiology, Marmara University, Faculty of Dentistry, Istanbul, Turkey.
International Endodontic Journal
|February 15, 2007
Summary
Arsenic trioxide used in root canal treatment can cause severe osteomyelitis due to leakage. This case highlights the risks of arsenic paste, necessitating surgical intervention for tissue necrosis.
Area of Science:
- Endodontics
- Oral Surgery
- Toxicology
Background:
- Arsenic trioxide was historically used for pulp devitalization before root canal treatment.
- Prolonged application or leakage of arsenic can cause toxic effects beyond pulp tissue.
Observation:
- A case of osteomyelitis was presented, stemming from arsenic trioxide leakage during root canal therapy on a mandibular left first molar.
- Severe tissue necrosis of periodontal tissues and supporting alveolar bone was observed.
Findings:
- The leakage of arsenic trioxide led to significant osteomyelitis and necrosis.
- Treatment involved sequestrectomy and excision of non-vital alveolar bone.
Implications:
- Dental practitioners must be aware of arsenic paste's potential to diffuse into surrounding tissues through various pathways.
- Osteomyelitis caused by arsenic trioxide requires combined pharmacotherapeutic and surgical treatment.
- Arsenic pastes are strongly advised against in modern endodontic practice due to associated risks.
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