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When the diameter of the stone is 5mm or less, it can be removed purely by an endoscopic technique, particularly when the stone is located above the muscles that comprise the floor of the mouth. The four common techniques used to remove the salivary gland stones are: The grasping technique; Using a small wire basket retrieval system
Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop salivary stones. The usual symptoms are pain and swelling of the affected salivary gland, both of which get worse when salivary flow is stimulated, e.g. with the sight, thought, smell or taste of food, or with hunger or chewing.
Many stone types can be detected by ultrasound; Factors contributing to stone formation (as in #Etiology) are often tested: Laboratory testing can give levels of relevant substances in blood or urine; Some stones can be directly recovered (at surgery, or when they leave the body spontaneously) and sent to a laboratory for analysis of content
Brushing and flossing can remove plaque from which calculus forms; however, once formed, calculus is too hard (firmly attached) to be removed with a toothbrush. Calculus buildup can be removed with ultrasonic tools or dental hand instruments (such as a periodontal scaler).
Embedded pulp stone is fully embedded in dentine and most commonly found in the apical portion of the root. Adherent pulp stones are attached to the wall of pulp space but not fully enclosed by dentine. Structurally, pulp stones can be classified as true and false pulp stones. True pulp stones are made up of dentine that is lined by odontoblast.
Stones may be removed by manipulation in the doctor's office, or, in the worst cases, by surgery. Lithotripsy, also known as "shock wave" treatment, is best known for its use breaking up kidney stones. Lithotripsy can now be used on salivary stones as well. Ultrasound waves break up the stones, and the fragments flush out of the salivary duct. [7]
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Besides, when interventional proecudre is planned such as stone removal from salivary ducts or dilatation of the strictures in the salivary gland, this procedure is also indicated. [4] However, for those who are pregnant, with allergy to iodinated contrast , and ongoing infection or inflammation of the face, the procedure is contraindicated.