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Foreign body gingivitis: an iatrogenic disease?

T D Daley1, G P Wysocki

  • 1Division of Oral Pathology, University of Western Ontario, London, Canada.

Oral Surgery, Oral Medicine, and Oral Pathology
|June 1, 1990
PubMed
Summary

Refractory gingivitis in patients may contain foreign material causing granulomatous inflammation. Energy-dispersive X-ray microanalysis identified elements suggesting iatrogenic sources in most cases.

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Area of Science:

  • Oral pathology
  • Materials science

Background:

  • Gingivitis refractory to conventional periodontal therapy presents a diagnostic challenge.
  • Histological examination is crucial for identifying underlying causes beyond typical periodontal disease.

Observation:

  • Biopsies from eight patients with refractory gingivitis showed granulomatous inflammation.
  • Foreign material particles were consistently found within these granulomatous foci.
  • Special stains for pathogens were negative, suggesting a non-infectious etiology.

Findings:

  • Energy-dispersive X-ray microanalysis detected elements like Calcium (Ca), Aluminum (Al), Silicon (Si), Titanium (Ti), and Phosphorus (P) in foreign particles.
  • Trace elements including Zirconium (Zr), Vanadium (V), Silver (Ag), and Nickel (Ni) were also identified in some specimens.
  • Clinical and elemental data suggested an iatrogenic origin for the foreign material in six out of eight patients.

Implications:

  • The presence of iatrogenic foreign material should be considered in refractory gingivitis cases.
  • Advanced analytical techniques like energy-dispersive X-ray microanalysis can aid in identifying the source of foreign material.
  • Further research is needed to resolve the origin of foreign particles in unresolved cases.

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