Oral exfoliative cytology and corrosion of metal piercings. Tissue implications



A group of adolescents with oral piercings was studied to determine the presence of metallic particles in cells exfoliated from the mucosa surrounding their metal oral piercings and the association between such particles and the metal jewelry, and to evaluate subsequent tissue implications.

Materials and methods

Sixteen teenage patients who had tongue and/or lip piercings were included. The clinical features of the oral mucosa and lip skin were evaluated. Exfoliative cytology was performed in the area surrounding the piercing. The surface of used and unused jewelry was studied by scanning electron microscopy and energy dispersive X-ray analysis.


Hyperplastic, leukoedematous, and lichenoid lesions were observed in the mucosa, as well as lesions associated with metallosis of the lip skin. Cytological smears showed the presence of particles inside the epithelial cells; the particles were found to contain aluminum, tungsten, and molybdenum. In one case requiring surgical removal of the piercing, histological examination of the tissue associated with the piece of jewelry showed the presence particles containing aluminum, iron, and tin inside multinucleated giant cells. Although surface finish defects were observed on both unused and used piercing jewelry, they were more evident on the used pieces.


Ion particles are released from the metal piercings and could have been adjuvant factors in the development of the observed lesions. Cells exfoliated from the oral mucosa surrounding metal piercings may serve as bioindicators of corrosion processes.

Clinical relevance

We propose the use of exfoliative cytology to monitor corrosion processes and for routine clinical follow up.

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This study was funded by the University of Buenos Aires (UBACyT 20020150100032BA and 0020130100332BA) and the National Council for Scientific and Technological Research, Argentina, (PIP 11220130100091).

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Corresponding author

Correspondence to Daniel Gustavo Olmedo.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the Statement of Ethics Principles of the School of Dentistry, University of Buenos Aires (Res (CD) 325/02).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Domingo, M.G., Ferrari, L., Aguas, S. et al. Oral exfoliative cytology and corrosion of metal piercings. Tissue implications. Clin Oral Invest 23, 1895–1904 (2019). https://doi.org/10.1007/s00784-018-2626-4

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  • Adolescents
  • Tongue and lip piercings
  • Metal jewelry
  • Corrosion
  • Metal surface finish
  • Exfoliative cytology