Pires Fábio Ramoa, Said Aurélio Marcos Tsutyia, Netto Juliana de Noronha Santos, da Cruz Perez Danyel Elias, Bonan Paulo Rogério Ferreti, Martins Helder Domiciano Dantas, Kaminagakura Estela, Alves Fábio de Abreu, Martelli Júnior Hercílio, Machado Renato Assis, Lopes Márcio Ajudarte, Santos-Silva Alan Roger, Vargas Pablo Agustin, Louredo Brendo Vinicius Rodrigues, Vega-Memije María Elisa, Cano-Aguilar Luis Enrique, Toussaint-Caire Sonia, Monteiro Mariene da Silva, Fonseca Thamyres Campos, Romañach Mário José, Abrahão Aline Correa, Aguirre-Urizar José Manuel, Lafuente Ibáñez-de-Mendoza Irene, Olmedo-Campos Mireya, Mosqueda-Taylor Adalberto
Oral Pathology, School of Dentistry, Rio de Janeiro State University, and Post Graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil.
Post Graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil.
Oral Dis. 2025 Mar;31(3):899-910. doi: 10.1111/odi.15143. Epub 2024 Oct 7.
To analyze the characteristics of a series of oral reactions to injectable soft tissue fillers.
Cases diagnosed as oral reactions to injectable soft tissue fillers were selected from eight Pathology laboratories. Information was retrieved from the laboratory charts and from the review of the hematoxylin and eosin-stained histological slides.
The 151 patients showed a mean age of 54.9 years, and 136 (90.1%) were females. Mean time of onset was 20.4 months, and the lips were the most frequent location (72.8%). Most cases presented as asymptomatic isolated nodules, with a mean size of 17.4 mm. Silicone (38.5%), polymethylmetacrylate (33%), and hyaluronic acid (11.9%) were the three most common fillers. Granulomas, foamy macrophages, and multinucleated giant cells were observed in 44%, 51.5%, and 65.3% of the cases, respectively. Time of onset was shorter for males (p = 0.033), and symptoms were common in the upper lip, buccal mucosa, and lower vestibule (p = 0.010). Foamy macrophages were more common in association with silicone and collagen (p < 0.001), whereas multinucleated giant cells were more common in association with polymethylmetacrylate, hydroxiapatite, and polylactic acid (p = 0.012).
Clinicians should consider reactions to injectable soft tissue fillers when evaluating asymptomatic submucosal nodules affecting the lips of adult/older females.
分析一系列注射用软组织填充剂引起的口腔反应特征。
从八个病理实验室选取诊断为注射用软组织填充剂引起口腔反应的病例。从实验室图表及苏木精-伊红染色组织学切片复查中获取信息。
151例患者的平均年龄为54.9岁，其中136例（90.1%）为女性。平均发病时间为20.4个月，唇部是最常见的发病部位（72.8%）。大多数病例表现为无症状的孤立结节，平均大小为17.4毫米。硅酮（38.5%）、聚甲基丙烯酸甲酯（33%）和透明质酸（11.9%）是三种最常见的填充剂。分别在44%、51.5%和65.3%的病例中观察到肉芽肿、泡沫状巨噬细胞和多核巨细胞。男性的发病时间较短（p = 0.033），上唇、颊黏膜和下前庭出现症状较为常见（p = 0.01）。泡沫状巨噬细胞在与硅酮和胶原蛋白相关的病例中更常见（p < 0.001），而多核巨细胞在与聚甲基丙烯酸甲酯、羟基磷灰石和聚乳酸相关的病例中更常见（p = 0.012）。
临床医生在评估影响成年/老年女性唇部的无症状黏膜下结节时，应考虑注射用软组织填充剂引起的反应。
