European Archives of Paediatric Dentistry

, Volume 17, Issue 5, pp 419–422 | Cite as

Arsenic trioxide-induced osteo-necrosis treatment in a child: mini-review and case report

  • M. MartyEmail author
  • E. Noirrit-Esclassan
  • F. Diemer
Case Report



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.

Case report

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.


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.


Arsenic trioxide Osteo-necrosis Endodontic 


Compliance with ethical standards

Conflict of interest

The authors declare having no conflicts of interest.

Financial support

This work received no specific grant from any funding agency, commercial or not-for-profit sectors.


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Copyright information

© European Academy of Paediatric Dentistry 2016

Authors and Affiliations

  1. 1.Department of Pediatric Dentistry, Faculté de Chirurgie-dentaire, Toulouse Dental SchoolUniversity of Toulouse IIIToulouseFrance
  2. 2.Department of Endodontics, Faculté de Chirurgie-dentaire, Toulouse Dental SchoolUniversity of Toulouse IIIToulouseFrance

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