SEM-EDX Analysis of a Submandibular Gland

SEM-EDX Analysis of a Submandibular Gland Salivary Calculus: A Case Report

A B S T R A C T

Sialolithiasis or “salivary lithiasis” is a pathological condition that involves the formation of calcified concrements within the gland parenchyma and its ductal system of the main salivary glands of the head and neck area. Various theories of lithogenesis have been reported, but the etiology of sialoliths still remains unclear. The aim of this case report was to evaluate the biochemical composition and the surface morphology of a sialolith using energy dispersion X-ray spectroscopy (EDX) and scanning electron microscopy (SEM). SEM images of the sialolith detected a concentric laminar architecture of the sialolith’s core surrounded by radial structures that are arranged from the center to the periphery of the sialolith. EDX analysis detected a high percentage of carbon in the central area of the sialolith, indicating the abundance of organic materials. Structures corresponding to a foreign body or bacteria were not detected in any area. Thus, the sialolith presented a mixed genesis, and the increased presence of organic substances over inorganic ones suggests its phlogistic nature.

Keywords

Sialolithiasis, salivary stones, EDX-SEM


Get access to the full version of this article.

Download PDF View PDF


Article Info

Article Type
Case Report

Publication history

Received:

Accepted:

Published:


Copyright

© 2023 Tonino Traini. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.

DOI: 10.31487/j.SCR.2021.01.17


Author Info

Raffaele Vinci

Bruna Sinjari

Imena Rexepi

Giammaria D’Addazio

Manlio Santilli

Massimiliano Di Giosia

Sergio Caputi

Tonino Traini


Corresponding Author
Tonino Traini
Department of Innovative Technologies in Medicine & Dentistry, University G. d’Annunzio Chieti-Pescara, Chieti, Italy

Get access to the full version of this article.

  1. Huoh KC, Eisele DW (2011) Etiologic factors in sialolithiasis. Otolaryngol Head Neck Surg 6: 935-939. [Crossref]
  2. Rzymska Grala I, Stopa Z, Grala B, Gołębiowski M, Wanyura H et al. (2010) Salivary gland calculi - contemporary methods of imaging. Pol J Radiol 3: 25-37. [Crossref]
  3. Andretta M, Tregnaghi A, Prosenikliev V, Staffieri A (2005) Current opinions in sialolithiasis diagnosis and treatment. Acta Otorhinolaryngol Ital 25: 145-149. [Crossref]
  4. Marchal F, Dulguerov P (2003) Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg 9: 951-956. [Crossref]
  5. Bodner L (2002) Giant salivary gland calculi: diagnostic imaging and surgical management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94: 320-323. [Crossref]
  6. Abdeen BE, Khen MA (2010) An unusual large submandibular gland calculus: a case report. Smile Dental J 5: 14-17.
  7. Harrison JD (2009) Causes, natural history, and incidence of salivary stones and obstructions. Otolaryngol Clin North Am 6: 927-947. [Crossref]
  8. Marchal F, Kurt AM, Dulguerov P, Lehmann W (2001) Retrograde theory in sialolithiasis formation. Arch Otolaryngol Head Neck Surg 1: 66-68. [Crossref]
  9. Koch M, Zenk J, Iro H (2009) Algorithms for treatment of salivary gland obstructions. Otolaryngol Clin North Am 6: 1173-1192. [Crossref]
  10. Pachisia S, Mandal G, Sahu S, Ghosh S (2019) Submandibular sialolithiasis: A series of three case reports with review of literature. Clin Pract 1: 1119. [Crossref]
  11. Terraz S, Poletti PA, Dulguerov P, Dfouni N, Becker CD et al. (2013) How reliable is sonography in the assessment of sialolithiasis? AJR Am J Roentgenol 201: W104-W109. [Crossref]
  12. Purcell YM, Kavanagh RG, Cahalane AM, Carroll AG, Khoo SG et al. (2017) The Diagnostic Accuracy of Contrast-Enhanced CT of the Neck for the Investigation of Sialolithiasis. AJNR Am J Neuroradiol 11: 2161-2166. [Crossref]
  13. Strychowsky JE, Sommer DD, Gupta MK, Cohen N, Nahlieli O (2012) Sialendoscopy for the management of obstructive salivary gland disease: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg 138: 541-547. [Crossref]
  14. Goncalves M, Schapher M, Iro H, Wuest W, Mantsopoulos K et al. (2017) Value of Sonography in the Diagnosis of Sialolithiasis: Comparison With the Reference Standard of Direct Stone Identification. J Ultrasound Med 11: 2227-2235. [Crossref]
  15. Kodaka T, Debari K, Sano T, Yamada M (1994) Scanning electron microscopy and energy-dispersive X-ray microanalysis studies of several human calculi containing calcium phosphate crystals. Scanning Microsc 8: 241-256. [Crossref]
  16. Lustmann J, Shteyer A (1981) Salivary calculi: ultrastructural morphology and bacterial etiology. J Dent Res 60: 1386-1395. [Crossref]
  17. Tanaka N, Ichinose S, Adachi Y, Mimura M, Kimijima Y (2003) Ultrastructural analysis of salivary calculus in combination with X-ray microanalysis. Med Electron Microsc 36: 120-126. [Crossref]
  18. Giray CB, Dogan M, Akalin A, Baltrusaitis J, Chan DCN et al. (2007) Sialolith characterization by scanning electron microscopy and X-ray photoelectron spectroscopy. Scanning 29: 206-210. [Crossref]
  19. Kasaboğlu O, Er N, Tümer C, Akkocaoğlu M (2004) Micromorphology of sialoliths in submandibular salivary gland: a scanning electron microscope and X-ray diffraction analysis. J Oral Maxillofac Surg 62: 1253-1258. [Crossref]
  20. Sadaksharam J, Kuduva Ramesh SS (2020) Spectroscopic and Microscopic Characterisation of Parotid and Submandibular Ductal Sialoliths: A Comparative Preliminary Study. Proc Natl Acad Sci India Sect B Biol Sci.
  21. Waseem BAZ, Forte V (2005) An unusual case of bilateral submandibular sialolithiasis in a young female patient. Int J Pediatr Otorhinolaryngol 69: 691-694. [Crossref]
  22. Grases F, Santiago C, Simonet BM, Costa Bauzá A (2003) Sialolithiasis: mechanism of calculi formation and etiologic factors. Clin Chim Acta 334: 131-136. [Crossref]
  23. Hammett JT, Walker C (2020) Sialolithiasis. In StatPearls, StatPearls Publishing: Treasure Island (FL).
  24. Su Y, Zhang K, Ke Z, Zheng G, Chu M et al. (2010) Increased calcium and decreased magnesium and citrate concentrations of submandibular/sublingual saliva in sialolithiasis. Arch Oral Biol 55: 15-20. [Crossref]
  25. Capaccio P, Torretta S, Ottaviani F, Sambataro G, Pignataro L (2007) Modern management of obstructive salivary diseases. Acta Otorhinolaryngol Ital 27: 161-172. [Crossref]
  26. Richardson GL (2008) Contemporary oral and maxillofacial surgery, 5th edition. Br Dent J 205: 109-109.
  27. Busso CS, Guidry JJ, Gonzalez JJ, Zorba V, Son LS et al. (2020) A comprehensive analysis of sialolith proteins and the clinical implications. Clin Proteomics 17: 12. [Crossref]
  28. Kraaij S, Karagozoglu KH, Forouzanfar T, Veerman ECI, Brand HS (2014) Salivary stones: symptoms, aetiology, biochemical composition and treatment. Br Dent J 217: E23. [Crossref]
  29. Szalma J, Böddi K, Lempel E, Sieroslawska AF, Szabó Z et al. (2013) Proteomic and scanning electron microscopic analysis of submandibular sialoliths. Clin Oral Investig 17: 1709-1717. [Crossref]
  30. Lee LT, Wong YKD (2010) Pathogenesis and diverse histologic findings of sialolithiasis in minor salivary glands. J Oral Maxillofac Surg 68: 465-470. [Crossref]