Mandibular bone necrosis caused by use of arsenic paste during endodontic treatment: two case reports

Abstract

Pulp-necrotizing agents such as arsenic trioxide can cause severe bone necrosis. Arsenical pastes have no place in contemporary dental practice. Dentists should employ appropriate local anaesthetic techniques for pulp extirpation instead of relying on toxic necrotizing agents.

A Tunnel Shape Defect on Maxillary Bone After Accidental Injection of Formocresol Instead of Anesthetic Solution

“…12,13 FC may affect the alveolar bone by leaking through caries lesions or a perforation. In addition, some cases have been presented with the gingival and bone necrosis caused by administering sodium hypochlorite instead of anesthetic solution.…”

Mandibular Osteonecrosis due to the Pulpal-Periodontal Syndrome: a Case Report and Review of the Literature

“…Usually, factors that lead to jaw osteonecrosis are known, however, there have been few case reports in the literature where no known factors for the development of osteonecrosis could be identified. The misuse of various chemicals in dentistry such as acid etchants, arsenic paste as well as paraformaldehyde containing pastes during endodontic treatment may cause damage to the gingiva and alveolar bone (5,6). Some dental techniques such as intraosseous anesthesia and prolonged rotation of the perforator drills in the bone might also lead to bone necrosis (8).…”

“…Osteonekrozu čeljusti mogu uzrokovati i lokalni čimbenici, poput traume nakon stomatološkog za-such as previous trauma caused by dental treatment (extraction of third molars, placement of rubber dam or injuries due to use of chemicals in dentistry, etc. ), bulimia or self-inflicted lesions in persons with psycological disturbances (4)(5)(6). Khullar et al (7) reported on the sixty cases of extreme osteonecrosis and osteomyelitis of the mandible and maxilla caused by coagulopathies and osteopetrosis, Gorham's disease, infective conditions (tuberculosis, herpes zoster, HIV and osteomyelitis), toxicity (bisphosphonates, spider bites) and environmental effects such as phossy jaw, radium jaw.…”

“…Iako su čimbeni-ci koji uzrokuju osteonekrozu čeljusti poznati, u literaturi je nekoliko prikaza slučajeva u kojima se ne mogu prepoznati uobičajeni uzročnici spomenutog stanja. Uporaba različi-tih kemijskih sredstava u dentalnoj medicini, poput kiselina za jetkanje, pasta koje sadržavaju arsen ili paraformaldehida tijekom endodontskog liječenja, mogu oštetiti gingivu i alveolarnu kost (5,6). Određeni zahvati, poput intraosealne anestezije i produžene rotacije svrdla za perforaciju u kosti, također mogu uzrokovati nekrozu kosti (8).…”

Rat subcutaneous tissue response to calcium silicate containing different arsenic concentrations

“…Due to its high toxicity, As may cause generalized tissue necrosis in the oral cavity when used for endodontic purposes 9 , 26 . A study by Duarte, et al 7 (2005) evaluated the release of As in two gray PCs, one white PC, MTA Angelus and MTA ProRoot and found similar As levels between the materials, much below the limit established by the ISO 9917-1 specifications 13 , which state that a material may only be used in dental procedures when it does not contain more than 2 mg of As per kg of material.…”