Giant submandibular gland duct sialolith mimicking an impacted canine tooth

Abstract

Sialolithiasis is the most common disease affecting the salivary glands and accounts for 80% of salivary gland disorders. Chronic sialolithiasis promotes stone formation. Size of the salivary stones may range from 0.1 mm to 30 mm or be even bigger. Those salivary stones, the size of which exceeds 15 mm in any one dimension or 1 g in weight are classified as giant sialoliths. Giant sialoliths of the submandibular gland duct are rarely reported. Here, we report a case of a giant sialolith of the submandibular gland duct mimicking an impacted mandibular canine tooth on routine radiographic examination and its surgical management through an intraoral approach.

A Case of Unusual Size Sialolith in the Wharton’s Duct

“…Stones can increase at a rate of 1-1.5 mm per year [6]. Stones larger than 15 mm in length or more than 1g in weight are called huge stones [7]. In this case, the stone volume was large, and there were no obvious symptoms in the early stage.…”

Giant sialolith mimicking an impacted tooth

“…Such presentation is rare 3. Following features should be used to differentiate sialolith from an impacted tooth on orthopantomogram; lack of sclerotic margins of lamina dura, absence of radiolucent central pulp chamber and differential radiolucency between enamel and dentin.…”

Two Cases of Submandibular Sialolithiasis Detected by Cone Beam Computed Tomography

“…Sialoendoscopy can be used for both diagnostic and treatment purposes [6]. It is mainly used in the treatment of inflammatory condition of the salivary glands and obstruction of the salivary ducts [2]. It is a technique for treating obstructions of the ductal system and can be used with operation in large salivary stones [6].…”

“…ESWL is an effective, noninvasive alternative approach in the surgical removal of salivary stones, reserving surgery for recurrent or complicating salivary lithiasis. The principle of ESWL is to reduce the size of calculi to small fragments, the diameter of which does not block the flow of saliva and can be washed away by natural flow [2]. Andertta et al [14] discussed the limitations of ESWL in the removal of stone with a diameter of >10 mm, as it is difficult to reduce the fragments and also in cases of acute inflammation.…”

“…The primary objective of treatment for giant sialoliths is the restoration of normal salivary secretion. The treatment options for submandibular sialoliths are intraoral removal of stone, interventional sialendescopy, resection of the gland [3] and extracorporeal shock wave lithotripsy (ESWL) [2]. The appropriate treatment method is chosen according to the size, location and number of sialoliths.…”