Allergic and Foreign Body Reactions
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Allergic and Foreign Body Reactions
Reactions to Dental Materials and Oral Health Care Products Definition
... Reactions to;
• Materials and foods. • Deliberate tattoos . ... Fragments of teeth, dental materials, glass and other materials traumatically introduced into the tissues . ... Shrapnel and other materials can also be accidentally introduced. ... Material close to the gingiva may produce foreign body gingivitis. Etiology
... Allergic reactions may be to oral health care products or foods or oth-
er antigens. ... Foreign bodies are introduced mainly in dental, sports or road traffic accidents, or assaults . ... Gingival inflammation associated with foreign bodies in the connective tissue is termed foreign body gingivitis (FBG). It is not commonly recognized by clinicians. It is more common in females. Most frequently, a red or red-and-white painful, chronic lesion, it has usually been present for less than 1 year and does not resolve with optimization of oral hygiene. It may be clinically confused with lichen planus. There is no gingival site predilection. Microscopically, foreign bodies are associated with the gingival inflammation, and elemental analysis suggests that they are usually derived from abrasives and less commonly from restorative materials. Gingival Involvement Other Sites of Involvement Main Clinical Features
... Rare ... Various ... There may be pigmentation (Fig. 99), inflammation (Figs. 100,
101),
whitish areas of necrotic epitheHum (Fig. 10:1) or sometimes, no features. Diagnosis
... Diagnosis is from history and clinical features. Wounds should always
be examined by: • Inspection. • Probing. • Imaging. • Ultrasonography (sometimes). Differential Diagnosis
... Naevus ... Neoplasm
G. Laskaris et al., Periodontal Manifestations of Local and Systemic Diseases © Springer-Verlag Berlin Heidelberg 2003
Chapter 11 • Allergic and Foreign Body Reactions FIGURE 99
Gingival pigmentation: deliberate tattoo
FIGURE 100
Contact gingivitis from chlorhexidine
FIGURE 101
Contact gingivitis from HexaIen
Chapter 11 • Allergic and foreign Body Reactions FIGURE 102
Contact gingivitis from cinnamon
Treatment
.. Laser or cryosurgery has been used to remove the foreign material. .. Foreign material is best removed at an early stage as it may eventually form: • Tattoos. • Granulomas. • Scars.
Materia Alba Definition
Etiology Gingival Involvement Other Sites of Involvement Main Clinical Features Diagnosis Differential Diagnosis
Treatment
.. Debris consisting of squames, food, microorganisms and other material .. Poor oral hygiene .. Common .. None .. Whitish plaques that easily can be removed with gauze (Figs. 103, 104) .. Diagnosis is from history and clinical features. .. Candidiasis .. Lichen planus .. Keratosis .. Oral hygiene
Chapter 11 • Allergic and foreign Body Reactions FIGURE 103
Materia alba
FIGURE 104
Materia alba
Reading List Daley TD, Wysocki GP (1990) Foreign body gingivitis: an iatrogenic disease? Oral Surg Oral Med Oral PathoI69:708-712 Goodman }R (1984) Fractured c
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