Unusual gingival reaction related to foreign body hydroxyapatite: a case report

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-03-14 DOI:10.1016/j.oooo.2025.01.017

Josefina Martínez-Ramírez, Sibele Nascimento de Aquino, Hélen Kaline Farias Bezerra, Mario Fernando de Góes, Alan Roger Santos-Silva, Pablo Agustin Vargas, Márcio Ajudarte Lopes

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Abstract

A 56-year-old woman was referred for evaluation and management of 2 asymptomatic vestibular gingival lesions in the areas of both upper lateral incisors. These 2 teeth were missing, and the areas were rehabilitated with dental implants and crowns. The patient reported that was previously treated in another service with systematic antibiotics and antiseptic mouthwash without resolution. She denied tobacco and alcohol use and her medical history includes a stroke medicated with clopidogrel. Clinical examination revealed 2 nodular lesions with erythematous and whitish areas on the marginal gingiva, with approximately 1 cm each. Cone beam computed tomography revealed extraosseous hyperdense particles along the bilateral buccal cortical bone of the dental implants. Microscopic examination showed intense chronic inflammation associated with numerous birefringent structures with rectangular and triangular shapes immediately subjacent to the epithelium. Energy-dispersive X-ray analysis revealed calcium and phosphate as the main elements of the foreign body, allowing comparison with pure hydroxyapatite to confirm the similarity in composition. The case is especially unique due to the identification of an enlarged gingival reaction to hydroxyapatite.

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异物羟基磷灰石所致牙龈异常反应1例

一位56岁的女性被推荐评估和处理2无症状前庭牙龈病变在两个区域的上侧切牙。这2颗牙缺失，用种植体和牙冠修复。患者报告说，以前在另一个服务系统治疗抗生素和抗菌漱口水没有解决。她否认吸烟和饮酒，她的病史包括服用氯吡格雷治疗中风。临床检查发现牙龈边缘有2个结节状病变，每个约1厘米，伴有红斑和白色区域。锥形束计算机断层扫描显示沿双侧颊皮质骨的骨外高密度颗粒。镜下检查显示强烈的慢性炎症伴大量双折射结构，矩形和三角形结构紧挨着上皮。能量色散x射线分析显示，钙和磷酸盐是异物的主要元素，可以与纯羟基磷灰石进行比较，以确认成分的相似性。由于对羟基磷灰石的牙龈反应扩大，该病例尤其独特。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.