This case report describes a scenario where a 14-year-old patient during orthodontic treatment at Solihull Hospital, West Midlands, presented with a rare soft tissue orthodontic complication. On routine examination, the spring coil from the orthodontic appliance was found to be located in the parotid gland duct. This was extracted by the oral and maxillofacial team at Solihull Hospital. The patient was followed post-operatively for any signs of sialadenitis, sialolithiasis and strictures. After 3 years of follow up, no post-operative complications were noted.
CPD/Clinical Relevance: Soft tissue and orthodontic complications are common, usually due to trauma from sharp components. Clinicians should be aware of complications that can also occur.
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Owing to the functional and structural features of the oral cavity, foreign bodies are rare. Additionally, because of the small components of orthodontic appliances, great care is taken in their design and placement.
Patients presenting with pain and swelling over the parotid gland usually have infective or obstructive sialadenitis. Obstructive sialadenitis may be due to calculi, fibromucinous plugs, duct stenosis, foreign bodies, anatomical variations, or malformations of the duct system leading to a mechanical obstruction associated with sialolithiasis. Sialolithiasis accounts for 66% of obstructive salivary disease.1 Strictures and kinks are the second most frequent cause of obstructive sialadenitis and involve the parotid duct in 75.3% of cases.1
Foreign bodies causing obstructive parotid sialadenitis are extremely rare. Only a handful of cases of foreign bodies in the parotid gland have been reported, and most were penetrative foreign bodies from the skin.
This case gives an example of a foreign body found within the parotid gland duct, associated with an orthodontic appliance.
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