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This paper describes a case of an intra-osseous foreign body impaction in the hard palate, a chicken bone fragment, in an adult male. The presentation mimicked that of an odontogenic lesion. Though palatal soft tissue foreign bodies in toddlers are well reported, the literature is sparse on cases involving adults. The location of the foreign body, and radiographic presentation, resulted in a diagnostic challenge to the attending clinician. This appears to be the first reported case of an animal bone presenting in this way in an adult.
CPD/Clinical Relevance: The case highlights the importance of credible history reporting, 3D imaging and developing accurate differentials in the diagnostic pathway when faced with an atypical clinical presentation.
Article
A 47-year-old male presented to his general dentist with a painful palatal swelling of 2 day's duration between the UR2 and UR1. He reported a history of a chicken bone lodged behind his front tooth 12 months previously that he had been unable to remove. He remembered a small swelling immediately following the incident, which resolved shortly after. No further care was sought, but at the time of presentation, the patient was convinced it was the source of his pain. His medical history was unremarkable, and no other history of trauma was reported.
The tender ovoid, firm palatal swelling measuring 1 x 1 cm in size, with no suppuration, extended from the mesial surface of UR1 to the distal surface of UR2. The surface did not blanch and was the colour of normal mucosa. The buccal attached gingiva in the region of UR2 and UR1 was erythematous and mildly tender. The UR2 was tender to percussion and palpation and demonstrated grade 1 mobility. Hygienic Endo-Ice Pulp Vitality Refrigerant testing with a cotton pledget indicated a vital pulp in UL1, UR1, UR2. All other anterior teeth showed no abnormal findings.
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