Marty M, Noirrit-Esclassan E, Diemer F
Department of Pediatric Dentistry, Faculté de Chirurgie-dentaire, Toulouse Dental School, University of Toulouse III, 3 chemin des Maraîchers, 31069, Toulouse, France.
Department of Endodontics, Faculté de Chirurgie-dentaire, Toulouse Dental School, University of Toulouse III, 3 chemin des Maraîchers, 31069, Toulouse, France.
Eur Arch Paediatr Dent. 2016 Oct;17(5):419-422. doi: 10.1007/s40368-016-0250-z. Epub 2016 Sep 9.
Arsenic oxide compounds were traditionally used as devitalizing agents. Due to its toxicity, leakage of such compounds into the periodontium can cause gingival and osteo-necrosis. Their use is forbidden in Europe and the USA for decades, however, some dentists seem to still use it.
We report the case of a 14-year-old girl referred to the paediatric dentistry department of Toulouse University hospital, France, presenting a bone necrosis following the use of an arsenic trioxide product to accelerate pulp necrosis.
The treatment included surgical removal of necrosis bone sequestrum, complete pulpectomy and an intermediate restoration of the tooth 27.
FOLLOW-UP: After 1 week, the clinical conditions greatly improved. A restoration using a ceramic crown was performed after 2 months, and complete healing was observed after 1 year follow-up.
Although arsenic trioxide is neither appropriate nor permitted for use in modern dentistry, especially in paediatric dentistry, some rare cases of arsenic-induced osteo-necrosis can still be encountered. A clearer message must be given to all dental practitioners against the use of arsenic trioxide in modern endodontic treatment.
氧化砷化合物传统上用作失活剂。由于其毒性，此类化合物渗漏至牙周组织可导致牙龈和骨坏死。在欧洲和美国，其使用已被禁止数十年，但仍有一些牙医似乎仍在使用。
我们报告一例14岁女孩的病例，该女孩被转诊至法国图卢兹大学医院儿童牙科，在使用三氧化二砷产品加速牙髓坏死后出现骨坏死。
治疗包括手术切除坏死骨痂、彻底的牙髓摘除术以及对27号牙进行临时修复。
1周后，临床状况大为改善。2个月后进行了烤瓷冠修复，随访1年后观察到完全愈合。
尽管三氧化二砷在现代牙科尤其是儿童牙科中既不合适也不被允许使用，但仍可能遇到一些罕见的砷诱导骨坏死病例。必须向所有牙科从业者更明确地传达反对在现代牙髓治疗中使用三氧化二砷的信息。
