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Arsenic trioxide-induced osteo-necrosis treatment in a child: mini-review and case report
M Marty1, E Noirrit-Esclassan2, F Diemer3
1Department of Pediatric Dentistry, Faculté de Chirurgie-dentaire, Toulouse Dental School, University of Toulouse III, 3 chemin des Maraîchers, 31069, Toulouse, France. martymat@hotmail.fr.
Background:
Arsenic oxide compounds were traditionally used as devitalizing agents. Due to its toxicity, leakage of such compounds into the periodontium can cause gingival and osteo-necrosis. Their use is forbidden in Europe and the USA for decades, however, some dentists seem to still use it.
Case Report:
We report the case of a 14-year-old girl referred to the paediatric dentistry department of Toulouse University hospital, France, presenting a bone necrosis following the use of an arsenic trioxide product to accelerate pulp necrosis.
Treatment:
The treatment included surgical removal of necrosis bone sequestrum, complete pulpectomy and an intermediate restoration of the tooth 27.
Follow-Up:
After 1 week, the clinical conditions greatly improved. A restoration using a ceramic crown was performed after 2 months, and complete healing was observed after 1 year follow-up.
Conclusion:
Although arsenic trioxide is neither appropriate nor permitted for use in modern dentistry, especially in paediatric dentistry, some rare cases of arsenic-induced osteo-necrosis can still be encountered. A clearer message must be given to all dental practitioners against the use of arsenic trioxide in modern endodontic treatment.
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