Foreign body gingivitis associated with a new crown: EDX analysis and review of the literature.

Gingival inflammation associated with foreign bodies in connective tissue is termed Foreign Body Gingivitis (FBG). It is not commonly recognized by clinicians and has recently been described fully in the literature. It is more common in females, and the incidence by age follows a normal distribution, unlike bacterially-induced gingivitis. Most frequently, a red or red-and-white painful, chronic lesion, it has usually been present for less than one year and does not resolve with optimization of oral hygiene. It may be clinically confused with lichen planus. There is no gingival site predilection. Microscopically, foreign bodies are associated with the gingival inflammation, and elemental analysis suggests that they are usually derived from abrasives, and less commonly from restorative materials. Treatment of FBG is still unclear and its prevention is discussed. A case is presented in which a patient developed localized foreign body gingivitis after placement of a crown. Elemental analysis using energy dispersive X-ray microanalysis (EDX) of the foreign particles was most consistent with an abrasive material.