Treatment with infliximab: Implications in oral surgery?

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British Journal of Oral and Maxillofacial Surgery
Volume 45, Issue 6, September 2007, Pages 507-510

Treatment with infliximab: Implications in oral surgery?
Marilou Ciantar and David M. Adlam, Department of Oral & Maxillofacial Surgery, Addenbrooke's Hospital NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, Cambridgeshire, United Kingdom
Accepted 13 June 2006. Available online 27 July 2006.

Abstract
Infliximab is a tumour necrosis factor-? (TNF-?) inhibitor (neutralising antibody), which is increasingly being used as an immunosuppressant to manage inflammatory conditions including rheumatoid arthritis, ankylosing spondylitis and Crohn's disease. Its side effects include diabetes mellitus, an increased incidence of lymphoma and greater susceptibility to infections such as pulmonary tuberculosis. In patients on infliximab, the oral cavity may act as a bacterial reservoir leading to unwanted local or systemic complications. To date no report describes the potential implication/s of infliximab in patients having oral surgery. This case report may be the first in the English language to report the development of mandibular osteomyelitis after surgical extraction in a patient on infliximab.

Keywords: Infliximab; Osteomyelitis; Third molar surgery; Pericoronitis; TNF-? inhibitors

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