Mandibular bone necrosis caused by use of arsenic paste during endodontic treatment: two case reports.
OBJECTIVE
To report that arsenical pastes are still employed in endodontics and to highlight the potentially serious consequences of their use.


CONCLUSIONS
Chemotherapeutic agents such as arsenic trioxide and paraformaldehyde were once commonly employed as pulp-necrotizing agents. Their cytotoxic effects are well recognized, and leakage from teeth has been associated with widespread necrosis of periodontal tissues and bone. This report describes two cases of severe bone necrosis affecting the mandible following the use of an arsenical paste.


CONCLUSIONS
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.
Yavuz
M S
MS
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Atatürk University, Erzurum, Turkey. mselimyavuz@gmail.com
Kaya
G Simşek
GS
Yalçin
E
E
Aras
M H
MH
D000328:Adult; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000009:adverse effects*; D003787:Dental Pulp Devitalization / Q000009:adverse effects* / Q000379:methods; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications; D005260:Female; D006801:Humans; D008336:Mandibular Diseases / Q000139:chemically induced*; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced*; D010087:Oxides / Q000009:adverse effects*
D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide