A case of oral foreign-body granuloma due to diatoms.

Diatoms are photosynthetic algae with a siliceous exoskeleton. Diatoms are utilized by a wide array of industries for applications such as filtration and pest control. Unsubstantiated claims have also propelled their societal reach to trendy oral and topical uses. This case highlights a rare case of an oral granuloma secondary to diatoms. An 80-year-old woman presented with a mobile, firm, asymptomatic submucosal mass on her lower left mandibular vestibular mucosa. Histopathology showed a non-caseating granulomatous reaction to diatoms. Her only verified contact with a diatomaceous earth product was a dental impression using alginate after upper front teeth trauma 5 months before. Although there have been several cases of allergic contact dermatitis attributed to diatoms, there are no reported cases of diatom-induced granuloma formation found in the literature. There are, however, ample data on granulomas initiated by silica. Given the silica-based composition of diatoms, and the broad use of diatoms in industry and alternative medicine, it is unclear why diatom-induced granulomas are not more widely described. This report may alert clinicians to the existence of diatom granulomas and incline them to tailor their history to cover questions about possible exposure when evaluating patients presenting with a localized oral lesion.

Assessment of occlusion after placement of stainless steel crowns in children - a pilot study.

Many stainless steel crowns (SSCs) disrupt the occlusion in children, but stabilisation appears to occur within a short period post-placement. The extent and mechanism of these short-term occlusal changes in children are unknown. This study sought to determine whether placement of a SSC changes the maximum intercuspation position (MIP) in children, whether the MIP returns to normal within 4 weeks and whether local anaesthesia had an effect on the child's ability to achieve MIP. The T-Scan(®) III was used for the measurement of occlusal contacts. Reliability and reproducibility of the system was determined using a calibration exercise where MIP recordings were taken of eleven children not undergoing any dental treatment. For the main study, the percentage of total occlusal force on each tooth was recorded in 20 children preoperatively, after local anaesthesia, after SSC placement and 4 weeks postoperatively. There was no significant difference in MIP (P = 0·435) preoperatively and post-administration of local anaesthesia. There was a significant difference between the preoperative force on a tooth and the reading after crown placement (P = 0·0013, Wilcoxon test). By 4 weeks, there was no significant difference overall between post-SSC placement and the preoperative value for the tooth (P = 0·3). Administration of local anaesthesia did not affect the ability of a child to attain MIP. Maximum intercuspation position was disturbed by the placement of a SSC in seven of 20 cases. When MIP was disturbed, in most cases, it returned to preoperative status within 4 weeks of crown placement.

The mechanism of gingiva metallic pigmentations formation.

The occurrence of blue-grey areas in the soft tissue represents one of the problems affecting patients whose teeth have been restored using metallic materials. It is generally accepted that it is caused by mechanical penetration of a metallic material into the soft tissue. Several facts indicate that this mechanism is not general. The aim of the study was to determine an alternative mechanism of the origin of pigmentations, based on the corrosion interaction of metallic materials used in prosthodontics with the oral environment. The study was comprised of an analysis of pigment particles, determination of exposure conditions of metallic materials in vivo and laboratory evaluation of corrosion properties of the studied materials. Particles containing silver, sulphur and/or selenium could be seen in ultra-thin sections in the lamina propria gingivae. Comparison of the corrosion laboratory results with the results of in vivo measurements indicated the intensification of corrosion under these conditions. Amalgams and silver-containing alloys used for teeth restorations may release silver under the conditions of the oral cavity. The formation of soluble silver compounds in the sulcular area or in a crevice between the crown and the cast post-and-core reconstruction facilitates their transport to the soft tissue and subsequent deposition.

[Metal intolerance. A frequent condition, but difficult to diagnose]. / Metall-Unverträglichkeit. Eine häufige Erkrankung, aber schwierig zu diagnostizieren.

Many of the methods and devices used for incompatibility testing of metals and alloys today are of questionable scientific value. Neither epicutaneous testing nor other diagnostic adjuncts from the realm of alternative medicine, nor patient-history data contained in so-called dental alloy passports, are generally able to yield any useful information. Analysis is particularly difficulty in situations where metallic components are cemented in place in the oral cavity. For many years now, the so-called splinter test has proven its value as a means of non-destructively identifying the type of alloy used. It can also be used for detecting persistent corrosion-prone adhesive oxides and soldering joints as causative agents of metal-related noxious processes. This article presents a number of case reports to demonstrate the reliability and the precision of the splinter test. Over a period of 10 years, more than 1600 splinter analyses have been performed at the University of Basle Center of Dentistry. According to a pertinent survey, these analyses were able to contribute to full treatment success in 63% of the cases, to partial success in 27% of the cases, and to no success in only 10% of the cases.

The influence of intracrevicular crown margins on gingival health: preliminary findings.

STATEMENT OF PROBLEM: The effect on gingival tissue of various crown materials in combination with different abutment biomaterials should be investigated. PURPOSE: This in vivo study determined the gingival health and subgingival levels of periodontal inflammation-associated bacteria adjacent to various crown and abutment material combinations. MATERIAL AND METHODS: . Patients in the study received 1 of 5 treatments: an all-ceramic crown luted to a natural tooth, a metal-ceramic (titanium) crown luted to natural tooth, a metal-ceramic (high noble alloy) crown luted to natural tooth, an all-ceramic crown luted to a titanium implant abutment, or a metal-ceramic (high noble alloy) crown luted to a titanium implant abutment. Plaque was collected at least 6 months after luting by paper point from the gingival sulcus of each crown and an adjacent unrestored (control) tooth. DNA probe analysis was performed to determine the levels of Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. In addition, plaque, gingival redness, swelling, and bleeding scores were recorded with use of the California Dental Association scale. Statistical analysis was used to determine the effect of restoration/abutment type on levels of the bacterial species and clinical parameters pertaining to gingival health. RESULTS: None of the sulci sampled contained detectable levels of the 3 bacteria. Plaque levels and gingival redness, swelling, and bleeding scores were low. All treatment groups had similar soft tissue response as measured by gingival redness, swelling, and bleeding. Plaque scores from all-ceramic crown/implant abutment sites were higher than plaque scores from all-ceramic crown/natural tooth sites. However, differences between experimental and control sites within the same treatment group were not observed (P>.05) with any of the 4 clinical measures. CONCLUSION: In patients with suitable oral hygiene, tooth-supported and implant-supported crowns with intracrevicular margins were not predisposed to unfavorable gingival and microbial responses.

Detection of selenium in generalized and localized argyria: report of four cases with X-ray microanalysis.

Electron microscopic and X-ray microanalytic studies were performed on four cases of argyria; one generalized and three localized. Deposition of electron dense granules was predominantly found on elastic fibers and around basal laminas of secretory portions of eccrine glands, although the amount of deposition was much less in the case of generalized argyria. In all four cases, X-ray microanalysis revealed that the depositions consisted mainly of silver, selenium, and sulfur. The importance of selenium in the detoxification of heavy metals was discussed.