Mandibular osteonecrosis involving tooth germ in children: A rare case report with a 6-year follow-up

Introduction Osteonecrosis involving permanent tooth germ in deciduous dentition is a rare condition that could affect the dental and maxillofacial development without correct intervention. Case presentation This case report presents a rare case of mandibular osteonecrosis involving one permanent tooth germ induced by arsenic trioxide in a 4-year-old Chinese girl. Clinical examinations revealed an unhealed wound with alveolar bone exposure, and radiographic evaluations suggested the necrosis of the surrounding alveolar bone. The sequestrectomy without extended curettage, and removal of the affected permanent tooth germ were performed along with systemic antibiotics therapy. No recurrence of the lesion and no complication were noted at six-year follow-up. Clinical discussion We presented a case of mandibular osteonecrosis in deciduous dentition with ideal prognosis after timely sequestrectomy without extended curettage. Although the disease-free edge is recommended for drug-induced osteonecrosis in adults, this treatment plan was made in reference to the only similar case and recovery potential of pediatric jaws. Conclusion This is the first drug-induced mandibular osteonecrosis case involving permanent tooth germ in children. Our results suggest that a conservative treatment regimen without extended curettage may be an option for young patients with osteonecrosis in jaws.