title: A Case of Periodontal Necrosis following Embolization of Maxillary Artery for Epistaxis.
abstract: Embolization of the maxillary artery (MA) is a common treatment modality for refractory epistaxis. Tissue necrosis after embolization of the MA is a rare complication. Here, we reported the first case of the development of necrosis of soft tissue and alveolar bone in the periodontium after embolization. A 48-year-old man with poor oral hygiene and a heavy smoking habit was referred to our clinic due to intractable epistaxis. After treatment with anterior-posterior nasal packing (AP nasal packing), the epistaxis relapsed. Therefore, he underwent embolization of the MA. Although he did not experience epistaxis after embolization, periodontal necrosis developed gradually. The wound healed with necrotomy, administration of antibiotics and prostaglandin, and hyperbaric oxygen therapy. We speculated that the periodontal necrosis was provoked by reduction of blood supply due to embolization and AP nasal packing based on this preexisting morbid state in the periodontium. Poor condition of the oral cavity and smoking may increase the risk of periodontal necrosis after embolization.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Kohei
authors.identifier: 0000-0001-6287-5898
authors.initials: K
authors.lastname: Nishimoto
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Ryosei
authors.identifier: 0000-0002-3830-2018
authors.initials: R
authors.lastname: Minoda
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yoshida
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto