Amalgam restoration or just a deposit? A riveting incidental finding- a case report
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CASE REPORT
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Amalgam restoration or just a deposit? A riveting incidental finding- a case report Anka Sharma1*, Vikrant O. Kasat1, Amit R. Parate1, Anirudh Upmanyu2 and Jaishri S. Pagare1
Abstract Background: Parafunctional oral habits are known to cause deleterious effects on maxillofacial structures. One such effect is traumatic injuries secondary to chewing inanimate objects like pencils. Following trauma, the lead of the pencil has been reported to embed in the soft tissue of the oral cavity, appearing as a grayish pigmentation (graphite tattoo). However, such pigmentation has never been reported in the hard tissue (teeth). Case presentation: We hereby report an interesting, first of its kind case in a four-year-old female child. She had been misdiagnosed and referred for the management of a carious tooth; which was, in reality, an exogenous deposit. Conclusions: The authors highlight the impact of comprehensive history taking on arriving at the diagnosis. Counselling of the child and the parents goes a long way in flouting such deleterious habits. Keywords: Amalgam, Deposit, Graphite, Habits, Case report
Background Habit is an unconsciously performed repetitive action. It is an integral part of maturation in children. These habits can be functional or parafunctional [1]. Functional habits result from repeating a function like nasal breathing, chewing, swallowing, phonation, etc. These habits are healthy and do not interfere with the normal growth and development of the child. On the other hand, parafunctional habits like digit sucking, lip biting, bruxism, and chewing inanimate objects (toys, pencils, chalk) are acquired from non-functional actions [2]. In the long run, persistence of these parafunctional habits has a major impact on the child’s orofacial musculature and jaw growth leading to complications like jaw size discrepancy, malocclusion, and traumatic injuries. Traumatic injuries of the orofacial region are very common amongst toddlers as they tend to fall easily due to incompletely developed muscular coordination [3]. * Correspondence: [email protected] 1 Department of Oral Medicine and Radiology, Government Dental College and Hospital, 431001 Aurangabad, Maharashtra, India Full list of author information is available at the end of the article
When a child falls with a foreign object in the mouth, for instance, a pencil, the lead may break and get embedded in the soft tissue causing pigmentation (graphite tattoo). Graphite tattoo of the soft tissue (palate, buccal mucosa) has been reported in the literature, but not very frequently [4]. However, such pigmentation has never been reported in the teeth. We hereby report an interesting, one of its kind case, where a grayish pigmentation on a molar tooth of a child was misdiagnosed as caries in a dental camp. She was referred to the present institute for restoration where it was again misdiagnosed, not as caries but as an amalgam restoration. The child’s habit of chewing pencils had led to lead (graphite) deposition on one of her teeth
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