Daley T D, Wysocki G P
Division of Oral Pathology, University of Western Ontario, London, Canada.
Oral Surg Oral Med Oral Pathol. 1990 Jun;69(6):708-12. doi: 10.1016/0030-4220(90)90353-t.
Gingival biopsy specimens from eight patients exhibiting a localized, erythematous, or mixed erythematous/leukoplakic gingivitis that was refractory to conventional periodontal therapy were examined histologically and by energy-dispersive X-ray microanalysis. Histologic examination revealed variable numbers of small, usually subtle, sometimes equivocal, and occasionally obvious foci of granulomatous inflammation. Special stains for fungi and acid-fast bacilli were consistently negative. In all cases, the granulomatous foci contained particles of foreign material that were often inconspicuous and easily overlooked during routine histologic examination. Energy-dispersive X-ray microanalysis of these foreign particles disclosed Ca, Al, Si, Ti, and P in most lesions. However, other elements such as Zr, V, Ag, and Ni were found only in specific biopsy specimens. By comparing the elemental analyses, clinical features, and history of the lesions, strong evidence for an iatrogenic source of the foreign material was found in one case, and good evidence in five cases. In the remaining two patients, the source of the foreign particles remains unresolved.
对8例患有局限性、红斑性或红斑/白斑混合性龈炎且对常规牙周治疗无效的患者的牙龈活检标本进行了组织学检查和能量色散X射线微分析。组织学检查发现有数量不等的小的、通常不明显、有时不明确且偶尔明显的肉芽肿性炎症灶。真菌和抗酸杆菌的特殊染色结果始终为阴性。在所有病例中，肉芽肿灶均含有异物颗粒，这些颗粒在常规组织学检查中常常不明显且容易被忽视。对这些异物颗粒进行能量色散X射线微分析发现，大多数病变中含有钙、铝、硅、钛和磷。然而，其他元素如锆、钒、银和镍仅在特定的活检标本中发现。通过比较元素分析、病变的临床特征和病史，在1例病例中发现了异物医源性来源的确凿证据，在5例病例中发现了充分证据。在其余2例患者中，异物颗粒的来源仍未明确。
