• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.1
• /
• pp.93-96
• /
• 2005

Sialolithiasis is the most common disease caused by calculi in a salivary gland and its duct. The pain and swelling of salivary gland is a chief complaint of patients presenting. Most salivary gland calculi occur in the submandibular gland, but can also occur in the parotid gland and the sublingual gland. One giant sialolith is rarely reported, while the several cases of one or multiple sialolith in the submandibular gland have reported in the literatures. In this case, we have removed the sialolith in which perforated mouth floor along Wharton's duct and report it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.2
• /
• pp.125-129
• /
• 2022

Sialolithiasis is a condition in which the salivary gland excretory duct is obstructed due to the formation of calcareous deposits and is uncommon in children compared to adults. The treatment modalities range from a conservative approach involving hydration to a surgical approach. Though several studies have analyzed the sialolith micromorphology structures, studies on pediatric sialoliths remain scarce. This brief communication aims to describe the sialolith micromorphology to understand the mechanism of mineralization and growth of pediatric sialoliths. A 6-year-old Korean female presented with swelling under her tongue. The intraoral examination revealed a painless yellowish hard mass beneath the tongue near the Wharton's duct which was suspected as a sialolith. After receiving the informed consent, the sialolithotomy was performed under local anesthesia. The obtained stone was analyzed through histopathology and transmission electron microscope examinations to understand the mechanism of mineralization and growth of pediatric sialolith. The micromorphology and growth processes of pediatric sialolith remain undescribed. More comprehensive microscopic studies are needed regarding their distinctive characteristics. By expanding knowledge about sialoliths micromorphology, development of new preventive, diagnostic and patient-tailored treatment methods of pediatric sialolithiasis will be enhanced.

• Journal of Oral Medicine and Pain
• /
• v.36 no.3
• /
• pp.161-167
• /
• 2011

Sialolith is one of the most common pathologic conditions found in the salivary glands. The mechanisms responsible for the formation of sialoliths have not been elucidated so far. In this article, the chemical composition and micromorphology of a sialolith of a 58-year old female patient suffering from chronic sialoadenitis of the submandibular gland was analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). In a SEM evaluation, the highly mineralized amorphous core surrounded by lamellar and concentric structures was revealed, however no foreign body, organic material, or signs of microorganism were observed in the core of the sialolith. EDX analysis showed the central core was composed of only Ca, O and P, and that a high level of C was detected near the central area as well. These results indicated that the inorganic composition of the sialolith was hydroxyapatite crystals, and that inorganic and organic substances existed around the central cores. This study suggests that the sialolith was composed mainly of hydroxyapatite crystals and the formation of the nucleus of the sialolith in the submandibular gland duct was secondary to sialadenitis, which favors the growth of an inorganic crystalline nucleus.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.4
• /
• pp.363-367
• /
• 2010

Sialolithiasis is the most commom disease of salivary gland. The main symptoms are pain and swelling of the involved gland during eating. It can occur at any age but patients in their third to fifth decade present most cases. Males are more frequently affected than females. Most sialoliths are located within the duct system of the submandibular gland. Submandibular sialoliths close to the hilum of the gland tend to become large and ovoid shape, whereas sialoliths in the duct tend to be elongated. Commonly, sialoliths measure from 1 mm to less than 10 mm, and larger than 15 mm are considered rare. In one case we have removed a giant sialolith which was located in a wharton's duct and in the other case we have removed multiple sialolith including a giant sialolith which were also located in a Wharton's duct. We report these 2 cases with literature reviews.

• The Korean Journal of Pain
• /
• v.31 no.3
• /
• pp.221-222
• /
• 2018

• Imaging Science in Dentistry
• /
• v.30 no.4
• /
• pp.255-257
• /
• 2000

Manufacturing method and technical procedure of 'SNU Sialoop', which was a new device designed for removal of sialolith, were introduced. Two cases about removal of Wharton's duct sialolith using SNU Sialoop were presented.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.1_2
• /
• pp.169-173
• /
• 1992

This is a report of two rare cases, that authors have experienced, one being four sialoliths within a wharton's duct, which is a relatively frequent site of sialolith, and the other a multiple occurrance of 16 sialoliths at the orifice of stensen's duct, which has very low frequency of sialolith occurance. Both pathosis were removed using transoral sialolithotomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.2
• /
• pp.145-148
• /
• 2021

Minor salivary gland sialolithiasis (MSGS) is a not uncommon oral mucosal disease. Its clinical appearance may mimic a mucocyst or other benign submucosal overgrowth. Stasis of saliva, which accompanies MSGS, usually results in minor salivary gland inflammation, with a chronic sialadenitis appearance. MSGS typically is a painless lesion but can become painful when the salivary gland parenchyma or excretory duct becomes infected, with or without pus. However, misdiagnosis of this condition is rather common, as the clinical appearance is asymptomatic. The most common location is the upper lip, and MSGS affects males and females, with a slight predilection for males. The sialolith causing MSGS may be obvious during surgical excision, as in the case reported. In other cases, sialolith may be absent or fragmented. Differential diagnosis includes mucocele, swelling due to local irritation like fibroma and diapneusia, chronic abscess of the oral mucosa, and neoplasms either benign (lymphangioma, pleiomorphic adenoma) or malignant. Histopathological examination is needed to establish clinical diagnosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.2
• /
• pp.94-102
• /
• 2024

The exact mechanism of sialolith formation has yet to be determined. Recurrence of sialolithiasis is rare, affecting only 1%-10% of patients. The current study presents a case of recurrent stones that occurred twice on the right submandibular gland 6 months postoperative and 7 months after reoperation in a 48-year-old female patient. The stones were analyzed using histology, scanning electron microscopy, energy dispersive spectroscopy, and transmission electron microscopy (TEM). The first stone showed a three-layered structure with a poorly mineralized peripheral multilayered zone, highly mineralized middle layer, and the central nidus. The stones were composed of Ca, C, O, Cu, F, N, P, Si, Zn, and Zr. In TEM, compact bi-layered bacterial cell membrane was found on the peripheral layer and the central nidus of the stone as well as exosomes in the central nidus. The results demonstrated the essential components of sialolith formation, including bacteria, inflammatory exosomes, and exfoliated salivary epithelial cells that cooperatively underwent the pathogenetic progresses of central nidus formation, induction of compact zone calcification of the middle layer, and repeated subsequent deposition in the peripheral multilayer zone. The rapid recurrence could have resulted from residual pieces of a sialolith acting as the nidus of bacterial infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.6
• /
• pp.548-552
• /
• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.