Year : 2008 | Volume
: 19 | Issue : 2 | Page : 160--161
Glass embedded in labial mucosa for 20 years
KN Sumanth1, Karen Boaz2, Naresh Y Shetty3,
1 Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Light House Hill Road, Hampankatta, Mangalore - 575 001, Karnataka, India
2 Department of Oral Pathology, Manipal College of Dental Sciences, Light House Hill Road, Hampankatta, Mangalore - 575 001, Karnataka, India
3 Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Light House Hill Road, Hampankatta, Mangalore - 575 001, Karnataka, India
K N Sumanth
Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Light House Hill Road, Hampankatta, Mangalore - 575 001, Karnataka
Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, etc. Few reports of glass pieces embedded in the soft tissues of the mouth have been published. We report a case where glass pieces had been lodged in the lower labial mucosa for 20 years, with consequent peripheral reactive bone formation.
|How to cite this article:|
Sumanth K N, Boaz K, Shetty NY. Glass embedded in labial mucosa for 20 years.Indian J Dent Res 2008;19:160-161
|How to cite this URL:|
Sumanth K N, Boaz K, Shetty NY. Glass embedded in labial mucosa for 20 years. Indian J Dent Res [serial online] 2008 [cited 2014 Dec 22 ];19:160-161
Available from: http://www.ijdr.in/text.asp?2008/19/2/160/40473
Foreign bodies may be ingested, inserted into a body cavity, or deposited into the body by a traumatic or iatrogenic injury. Most foreign bodies cause abscess formation, septicemia, or lead to severe hemorrhage; they can also undergo distant embolization. Motor vehicle accidents, assaults, and bullet wounds are common causes of traumatic foreign bodies.  Foreign bodies, and tissue reactions to foreign materials, are commonly encountered in the oral cavity. The more common iatrogenic lesions include apical deposition of endodontic materials, mucosal amalgam and graphite tattoos, myospherulosis, oil granulomas, and traumatically introduced dental materials and instruments. 
We are reporting an interesting case of a foreign body in the oral cavity.
A male patient, 34 years of age, came to the department of oral medicine with the chief complaint of missing and fractured teeth. The teeth had been fractured and lost 20 years back in a road traffic accident. There was no history of any associated bone fracture; some soft tissue injuries had been treated by a local doctor. Since then he had been asymptomatic. Medical, family, and past dental history were non-contributory. On examination, a scar was noticed on the left side of the chin. A swelling was present in the labial vestibule in relation to teeth 42 and 43, and a scar was observed in the labial vestibule corresponding to 32 [Figure 1]. The swelling was solitary, nodular, tender on palpation, and hard in consistency. A mobile, hard mass was palpated within the swelling. The overlying mucosa was pale and there were no signs of inflammation. Tooth 21 was fractured (Elli's class 2) and 42 and 43 were tender on percussion. Cervical lymph nodes were not palpable.
Intraoral periapical (IOPA) radiograph revealed a well-defined radiopacity and two faint radiopacities overlapping the roots of the lower anterior teeth [Figure 2]. A lateral view of the chin was also taken using an IOPA film, which revealed three discrete, well-defined radiopacities in the labial vestibule with periosteal bone formation [Figure 3]. A provisional diagnosis of foreign body embedded in soft tissue was considered.
The patient was referred to the department of oral and maxillofacial surgery for the removal of the foreign body. A lower labial incision was placed and a flap raised [Figure 4]. Three small pieces of glass were identified and removed. Labially, a bony prominence was found adjacent to the glass pieces and was reduced. Postoperative wound healing was uneventful.
The visibility of different materials on plain radiographs depends on their ability to attenuate x-rays; foreign bodies may be visualized, depending on their inherent radiodensity and proximity with the tissue in which they are embedded.  Metallic objects, unless made of aluminum, are opaque on radiographs, as are most animal bones and all glass foreign bodies. Most plastic and wooden foreign bodies and fish bones are not opaque on radiographs. Regular nonleaded glass is radiographically visible and the factors such as color and location of the glass have no effect on its visibility; however, a volume of less than 15 mm 3 may have an effect, making it less likely to be visible.  Here, the glass pieces were only faintly visible in the IOPA due to the overlapping structures like alveolar bone and teeth, but a lateral view of the labial vestibule showed the glass pieces distinctly.
In patients who have had a penetrating injury, the nature of the foreign body determines the clinical behavior; inert objects such as steel and glass may not cause significant inflammation to warrant their removal.  The possibility of glass causing a granulomatous reaction cannot be ruled out. There are case reports of granuloma formation and sarcoid-like lesions in patients who have inhaled glass fibers.  Removal of organic foreign bodies is however mandatory, since these objects usually lead to secondary infection, with abscess and fistula formation. In our case, though the foreign body was inert glass, it had induced scarring and reactive bone formation in the adjacent bone. This could be attributed to the periosteal stimulation due to chronic irritation induced by the glass pieces.
|1||Hunter TB, Taljanovic MS. Foreign bodies. Radiographics 2003;23:731-57.|
|2||Stewart CM, Watson RE. Experimental oral foreign body reactions: Commonly employed dental materials. Oral Surg Oral Med Oral Pathol 1990;69:713-9.|
|3||Mahale AR, Shetty R, Venugopal A, Kumar A. Radiological detection of unsuspected foreign bodies- letter to editor. Indian J Radiol Imaging 2002;12:134.|
|4||Arbona N, Jedrzynski M, Frankfather R, Lo AE, Hetman J, Mendicino SS, et al . Is glass visible on plain radiographs? A cadaver study. J Foot Ankle Surg 1999;38:264-70.|
|5||Drent M, Bomans PH, Van Suylen RJ, Lamers RJ, A Bast, Wouters EF. Association of man made mineral fibre exposure and sarcoid like granulomas. Respir Med 2000;94:815-20.|