A radicular cyst potentially associated with unsupervised home bleaching: A multidisciplinary case report

Radicular cysts are common odontogenic cysts typically resulting from pulp necrosis secondary to caries or trauma. However, their possible association with the use of household bleaching agents is extremely rare. his report describes a unique case of a radicular cyst potentially induced by self-administered home bleaching, highlighting the need to recognize unconventional causes of pulpal injury. A 21-year-old female presented with a recurrent cutaneous fistula on the chin that persisted despite prior surgical and antibiotic management. Radiographic and histopathological examinations confirmed an odontogenic cyst in the mandibular anterior region (teeth 31–42). Further history revealed unsupervised use of a hydrogen peroxide–based household bleaching agent for tooth whitening prior to the onset of symptoms, with both teeth exhibiting pulp necrosis on clinical examination. The patient was treated through a multidisciplinary approach involving cyst enucleation, root canal therapy, apicoectomy of teeth 41 and 42, and fistula reconstruction under general anesthesia. Botulinum toxin was also administered to the masseter muscle to manage concomitant bruxism as a potential contributing factor. This rare case underscores the potential risks of unsupervised dental bleaching and the importance of comprehensive etiological evaluation in recurrent orocutaneous fistulas. A multidisciplinary approach is essential for optimal functional and esthetic outcomes. • An orocutaneous fistula developed as a rare complication of an untreated radicular cyst. • A rare case of radicular cyst formation following unsupervised home bleaching is presented. • Radiographic and histopathologic findings confirmed the diagnosis of a radicular cyst. • Botulinum toxin was administered post-enucleation to control bruxism and reduce masticatory stress on the healing bone.