Coronal fracture with insertion of the fragment in the lower lip: Case report

INTRODUCTION: The presence of a foreign body (any object or structure that is outside its ideal location) should be considered in any head and neck injury. Foreign bodies can remain dormant in soft tissues for years without causing damage, however, their presence can induce a complex acute or chronic inflammatory reaction of the foreign body type, which results in symptoms for the patient. For a correct diagnosis and treatment plan, a detailed clinical examination combined with imaging tests is necessary. OBJECTIVE: The aim of this study was to report a clinical case of accidental inclusion of composite resin fragments in the lower labial mucosa and the approach adopted for the case. CASE REPORT: A female patient with a class IV restoration in element 21 fell from her own height, resulting in fracture of the restoration and insertion of composite resin fragments into the lower labial mucosa. The case was treated with conservative surgery to maintain lip esthetics. Histopathological examination revealed vascularized fibrous connective tissue and amorphous material associated with the presence of epithelioid lymphocytes, confirming the diagnostic hypothesis of the presence of a foreign body. Three months after the surgery, a new extraoral radiograph of the lower labial mucosa also revealed the presence of fragments of composite resin in the tissue. The patient was informed that a new surgery would have to be carried out to remove the foreign body. CONCLUSION: A detailed clinical examination combined with imaging tests is essential for a correct diagnosis. Surgical removal, although often challenging, is indicated in order to avoid future complications. Histopathological analysis of the removed material should always be carried out as part of case management.