Sequester of the mandible caused by root canal irrigation.

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A 35-year-old male patient, who had undergone root canal therapy of the 6 tooth 6 weeks previously, suffered swelling and pain of the right lower jaw after root canal irrigation with 10% sodium hypochlorite and hydrogen peroxide. Even after extraction of the 6 tooth, the symptoms did not diminish, and the patient visited our department. He showed no abnormal systemic findings but had a diffuse and hard osseous swelling of the right lower jaw and anesthesia of the right lower lip and skin in the right mental region. In the oral cavity, the gingiva of the 765 teeth showed redness and swelling, and the bone was exposed at the 6 extraction wound along with pus discharge. Although roentgenography showed no definite changes in the jaw bone, the lower jaw bone of teeth 7 to 5 teeth showed an image of irregular bone resorption with features of sclerosing one month after the initial examination. Three months after administration of an antibiotic agent and an antiphlogistic one as well as local irrrigation with physiological saline solution, a sequester was excised. All of the subjective symptoms disappeared 10 months after the treatment.
日本歯科薬物療法学会の論文