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176:Oral Exuberant Foreign-body Granulomatous Inflammation In A Patient With Sarcoidosis[AAOM2021]
EP36051
Poster Title: 176:Oral Exuberant Foreign-body Granulomatous Inflammation In A Patient With Sarcoidosis[AAOM2021]
Submitted on 29 Mar 2021
Author(s): Andres Davila, Ayman Alaraik, Katherine France, Adeyinka Dayo, Takako I. Tanaka, Faizan Alawi, Eric T. Stoopler, Thomas P. Sollecito
Affiliations: University of Pennsylvania, United States of America
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 322
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Poster Information
Abstract: Background

Granulomatous inflammation is a distinctive form of inflammation with multifactorial etiology and variable clinical findings. Etiology of oral granulomatous lesions may be idiopathic, genetic, infectious or acquired through impregnation of foreign substances, including dental materials. Sarcoidosis is a multisystemic disease characterized by non-necrotizing granulomas. Oral sarcoidosis is considered relatively rare.

Case Summary

A 70-year-old female was referred with a chief complaint of a continuous dull pain in the right posterior mandible following the extraction of the second premolar and second molar. Five years before the extractions she had the first molar extracted with immediate bone and soft tissue grafting, followed by placement of a fixed bridge. Her medical history include hyperthyroidism, and sarcoidosis localized to the intrathoracic lymph nodes. Review of system was negative for pulmonary symptoms. Examination revealed healing extraction sockets. A biopsy performed during the extraction procedure revealed a chronic granulomatous inflammatory reaction with giant cells to foreign material. CBCT imaging revealed a large bony defect. A CBC, CMP including calcium, alkaline phosphatase, phosphorus, ESR, and CRP were ordered to rule out secondary infection, an inflammatory or continued osteolytic processes. Alkaline phosphatase was slightly elevated. Two months later the soft tissue of the edentulous ridge was without lesions. Her pain subsequently resolved, and she is being closely monitored for any recurrence.

Conclusion

The findings above suggest an exuberant foreign body granulomatous inflammatory reaction to the grafting material in the setting of a patient with sarcoidosis. This case is presented to illustrate the association between exuberant foreign body granulomatous inflammation with localized dentoalveolar destruction as can be seen in a patient with underlying sarcoidosis
Summary: Granulomatous inflammation is a distinctive form of inflammation with multifactorial etiology and variable clinical findings. Etiology of oral granulomatous lesions may be idiopathic, genetic, infectious or acquired through impregnation of foreign substances, including dental materials. Sarcoidosis is a multisystemic disease characterized by non-necrotizing granulomas. Oral sarcoidosis is considered relatively rare.

Ask the author questions about this poster:daviladmd@gmail.com
References: 1) Alawi, Faizan. “An update on granulomatous diseases of the oral tissues.” Dental clinics of North America vol. 57,4 (2013): 657-71. doi:10.1016/j.cden.2013.07.004
2) Chen, Edward S, and David R Moller.“Sarcoidosis--scientific progress and clinical challenges.” Nature reviews. Rheumatologyvol. 7,8
457-67. 12 Jul. 2011, doi:10.1038/nrrheum.2011.93
3) Suresh, L, and L Radfar. “Oral sarcoidosis: a review of literature.” Oral diseases vol. 11,3 (2005): 138-45. doi:10.1111/j.1601-0825.2005.01014.x
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