A Case of SAPHO Syndrome with Endodontic Implications and Treatment with Biologic Drugs

摘要: Abstract SAPHO syndrome (SS) is an autoinflammatory disease characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis. Among the sites affected osteoarticular manifestations of SS are anterior chest wall mandible. The etiology still unknown; theories advocate a genetic predisposition infectious cause in association with disorders immune system. We report case which there was involvement mandible lesion endodontic origin. A 44-year-old white woman diagnosed at university hospital referred to Department Conservative Dentistry Endodontics for consultation. She reported spontaneous pain localized periapical area tooth #19 history multiple restorative treatments. It as previously treated symptomatic apical periodontitis (AP) time evaluation. second retreatment then performed 1 appointment under local anesthesia. During retreatment, separated instrument ledge were found mesiobuccal canal, attempts bypass it not successful; canal obturated reachable length. Within same month, patient also administered anti–tumor necrosis factor alpha biologic medication disease-modifying antirheumatic drugs treatment SS. 3 months, overall therapy had led marked improvement systemic mandibular symptoms, radiograph showed almost complete healing lesion. Medical examinations have shown total remission signs symptoms starting 6 months after initiation treatment. After 5 years, control, symptom free shows absence AP. endodontists need be aware existence possible effects use medications on persistent