PMC9843066_01
(A) Panoramic radiography: no noticeable image regarding 46. (B) Axial CT section: Plurilamellar periosteal reaction at the vestibular cortex in front of 46 (white arrows). (C) Axial CT section: osteolysis (star) in front of 46 with deformation and destruction of the vestibular cortex (black arrows). (D) Coronal CT section: osteolysis in continuity with the oral cavity through a periodontal pocket (white arrowhead). (E) Sagittal CT reconstruction: destruction of the vestibular cortex. (F, G) Axial and coronal CT sections in a narrow window: thickening of the masseter muscle (M) with extension toward the buccinator (B). (H) Microscopic observation: polymorphic granulation tissue of lymphocytes, plasmocytes, neutrophils, and multinucleated giant cells (black arrows), surrounding in some areas the vegetable debris (black arrowheads) associated with numerous hyperplastic vessels.
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The panoramic radiograph (Figure 1A) was featureless. CT scan revealed a well-limited hypodense image without a condensation line, facing the vestibular side of the (46) and destroying the vestibular table from the outset (Figure 1C-E). The multilamellar periosteal reaction was also noted (Figure 1B). Narrow window sections (Figure 1F,G) revealed thickening of the masseter muscle and a partial thickening of the buccinator. Biopsy confirmed the diagnosis of a vegetable foreign body inflammatory granuloma (Figure 1H).