Bilateral Oroantral Fistulas Following Devitalization Of Teeth By Arsenic Trioxide: A Case Report

Abstract

Although it is well known that prolonged application or leakage of arsenic trioxide can cause severe damage to the periodontal tissues, the substance is still used by some dentists. This paper describes a case of arsenical necrosis of the jaws affecting the right and the left side of the maxilla. As a result of leakage into the tissues of an arsenical paste from the pulp chamber of endodontically treated teeth, bilateral oroantral fistula (OAF) occurred. It is concluded that there is no justification, whatsoever, for the use of arsenic in modern dental practice. In the following case, buccal advancement flap and submucosal palatal island flap techniques were used for to close the OAF. The submucosal palatal island flap technique resulted in successful closure of the OAF.

Buccal fat pad versus sandwich graft for treatment of oroantral defects: A comparison

“…Materials range from autogenous bone grafts[12] to gold foil[3] for closing OAF. [11] In recent years, the use of a pedicle BFP in closure of large oroantral openings has become popular. [2] Distant flaps from the extremities or forehead or tongue flaps have been described by Edgerton and Zovickian,[13] and Guerro-Santos and Altamirano.…”

“…[11] An OAC was closed by applying a buccal fat pad (BFP)-pedicle BFP graft. [2] It is used in patients with a fistula of 8–20 mm in diameter.…”

Arsenic Trioxide-Induced Mandibular Osteomyelitis

“…A C C E P T E D ACCEPTED MANUSCRIPT 9 In conclusion, arsenic trioxide is nontherapeutic and highly toxic for use in endodontic treatment. There is no current indication for its use.…”

“…Yakata et al5 reported a patient who exhibited extensive bone destruction that affected not only the involved teeth, but also the entire ascending ramus. Yalcin et al9 documented the details of a patient who developed bilateral oroantral fistulae due to leakage of arsenic paste from the dental pulp chamber into the local tissues. Garip et al2 described the management of arsenicinduced osteomyelitis.…”

Repair of Oronasal fistula with Split-thickness Palatal graft

“…Other varieties of graft materials have been used in place of bone, including tantalum 8 , freeze-dried collagen 10 and fascia lata, Duramater 11 . An OAC was closed by applying a buccal fat pad (BFP)-pedicle BFP graft 2 .…”