Chemically induced osteomyelitis in the mandible: A case report

ABSTRACT

drugs and materials used in dentistry can induce severe toxicity or immune responses. Root canal irrigants used during endodontic treamtent and chemical agents used for devitalization at the time of pulp extirpation are especially known to induce toxicity. We experienced a case of acute osteomyelitis developed in the mandible in a 37-year-old woman during endodontic treatment. Endodontic treatment was performed using a paraformaldehyde-containing material. One month later, extensive bone necrosis was developed in the alveolar bone and adjacent teeth. Bone scintigraphy and radiographic findings showed the presence of a definite bony lesion in the right mandible. So acute suppurative osteomyelitis was diagnosed. The patient was treated by the extraction of the affected teeth and the removal of necrotic bone under general anesthesia. She recovered normally after 2 weeks of antibiotics treatment. Such a case of suppurative osteomyelitis developing during a relatively short period of endodontic treatment is very rare. We believe that the patient developed osteomyelitis due to toxicity coming from chemicals used during the endodontic treatment. Thus, we report this case and present a literature study on several drugs that can induce toxicity and complications among dental materials presently used in dentistry.