title: Granulomatosis associated to porcelain wear debris.
abstract: OBJECTIVE
  To determine the origin of a cryptogenic granulomatosis using an innovative diagnosis technique.
  
  
  METHODS
  A patient affected by fever of unknown origin for 9 years was diagnosed with colestasis and acute renal failure with pathological evidence, in parenchimal samples, of granulomatosis of unknown origin. New scanning electron microscopic observations on the biopsy samples from the liver and the kidney and x-ray elemental microanalyses showed the presence of debris made of silicone, aluminum, sodium and potassium, and aluminum-silicate similar to dental porcelain. The same SEM and x-ray analyses were carried out on the patient's worn porcelain dental bridges.
  
  
  RESULTS
  A correlation was demonstrated between wear debris of porcelain and the cryptogenic granulomatosis, which lead to a different therapeutic approach and the removal of the origin of the debris; this stabilized the situation and caused an improvement of the disease. The results indicated that a material can be biocompatible when used in a solid bulk, but this property can be lost when it is degraded into small particles.
authors.affiliation: Laboratory of Biomaterials, Department of Neurosciences, National Institute for Physics of Matter, University of Modena and Reggio Emilia, Modena, Italy. gatti@unimo.it
authors.forename: Antonietta M
authors.initials: AM
authors.lastname: Gatti
authors.forename: Marco
authors.initials: M
authors.lastname: Ballestri
authors.forename: Alberto
authors.initials: A
authors.lastname: Bagni
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects*; D003776:Dental Porcelain / Q000009:adverse effects* / Q000737:chemistry; D019554:Dental Restoration Wear; D003830:Denture, Partial, Fixed / Q000009:adverse effects*; D004577:Electron Probe Microanalysis; D005243:Feces / Q000737:chemistry; D005335:Fever of Unknown Origin / Q000209:etiology; D015745:Granuloma, Foreign-Body / Q000150:complications / Q000209:etiology* / Q000473:pathology; D006529:Hepatomegaly / Q000209:etiology / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D001672:Biocompatible Materials; D003776:Dental Porcelain