Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review

Background: Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck. Material and methods: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts. Results: A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications. (AU)

The tooth as a monitor of cholestatic liver disease in rats.

OBJECTIVE: Measure, noninvasively, the deposition of bilirubin in the tooth by using DIAGNOdent and correlate it to liver dysfunction. STUDY DESIGN: After confirming the capacity of DIAGNOdent to measure varying bile concentrations in plaster blocks, a cholestatic liver disease model was studied to detect increasing bilirubin impregnation in the teeth of rats. Wistar-EPM rats (n = 50) were divided into three groups: (1) BDL: rats submitted to bile duct ligation (BDL); (2) Naïve: rats without procedure; and (3) Sham: rats submitted to laparotomy without BDL (n = 10/period/group). The rats' teeth were monitored with the use of DIAGNOdent before the procedure and at days 10 and 50 following surgery. Serum bilirubin was also monitored. RESULTS: Tests in vitro showed that DIAGNOdent detected bile in plaster blocks according to its concentration. BDL promoted progressive liver dysfunction, with death occurring approximately 50 days later. DIAGNOdent values obtained on teeth showed correlation with the progression of serum hyperbilirubinemia. CONCLUSIONS: The tooth was found to be a good tissue for noninvasively monitoring the progression of bilirubinemia in cholestatic liver disease in rats by using DIAGNOdent.