Alveolar Bone Necrosis and Tooth Loss Unusual Complication of Herpes Zoster: A Report of Two Cases

Abstract Herpes zoster (HZ) is caused by reactivation of the varicella-zoster virus (VZV), with well-known oral soft tissue manifestations. However, reports of spontaneous tooth exfoliation and jaw bone necrosis secondary to HZ infection remain exceedingly rare, with only 58 cases reported to date. Incidence of HZ infection increases sharply with age. This report presents two rare cases of HZ involving the mandibular and maxillary divisions of the trigeminal nerve. Both the cases were immunocompromised and reported late with a history of typical prodromal symptoms and alveolar bone necrosis along with multiple tooth losses. Clinical presentation of both the cases required urgent intervention to prevent further complications. Early diagnosis and start of antiviral therapy can reduce the risk of severe complications. The most common complications of HZ are postherpetic neuralgia, bone necrosis, and spontaneous loss of teeth.