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KMID : 1146620140030020071
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Journal of Korean Academy of Advanced General Dentistry
2014 Volume.3 No. 2 p.71 ~ p.77
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Chronic Foreign Body Reaction of Mandible and Separate Facial Subcutaneous Fibrosis Following Overextension of Calcium Hydroxide: Case Report
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Lee Ji-Hye
Hong Mi-Hee
Kim In-Soo
Lee Won
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Abstract
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A 13-year-old female with no past medical history presented to the clinic for the management of lower right facial swelling and pain during the past 6 months. The radiologic and computerized tomographic scan showed scattered radiopaque material surrounding the extraction area of the right lower first molar. The material was calcium hydroxide paste accidently extruded about 1 year ago according to the patient’s private dentist. The patient developed abscess of the buccal space and separate facial subcutaneous lesion. On the basis of her past dental history, it was concluded that the chronic inflammatory reaction was originated from chemical trauma of calcium hydroxide. Buccal space abscess was treated with intraoral buccal mucosal incision and drainage insertion under local anesthesia. Although symptoms showed slight improvement, inflammatory reaction still remained and localized facial lesion required surgical removal. Under general anesthesia, necrotic bone and facial subcutaneous lesion was surgically removed respectively. A histopathologic analysis of necrotic bone tissue revealed a chronic inflammatory foreign body reaction. The separate facial subcutaneous lesion showed chronic inflammatory cell infiltration with fibrosis. After an observation period of 6 months, healing was uneventful. This report illustrates the late foreign body reaction of extruded calcium hydroxide paste and the development of separate facial lesion.
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KEYWORD
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Calcium hydroxide, Root canal therapy, Foreign-body reaction
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