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Sandre LB, de Paula E Silva E, Izidro AER, Neto WMP, da Costa Moraes CA, da Rosa ELS. Observational and descriptive analysis of broken dental needles: a case series. Oral Maxillofac Surg 2023; 27:433-443. [PMID: 35661006 DOI: 10.1007/s10006-022-01078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To discuss potential causes of broken dental needles during dental anesthesia and features of this complication, including the anatomical location of fragments in tissues, symptoms, complications, and therapeutic approaches. METHODS Twelve cases of broken dental needles occurring during dental anesthesia and subsequently referred to Hospital de Base do Distrito Federal, Brazil, between 1992 and 2019 were selected. In addition, similar cases reported in the literature over the past 50 years were reviewed. RESULTS Needle fractures occur most frequently during inferior alveolar nerve blocks and in younger patients. The leading cause is unexpected patient movement during the anesthetic procedure. The needle fragment is most commonly found in the pterygomandibular space or the deep spaces of the head and neck region. Needle migration is a particular concern; although rare, it is unpredictable and potentially life-threatening. CONCLUSIONS Needle fracture is an intraoperative complication which has the potential to cause severe patient damage. It is essential that practitioners have knowledge of this possible complication and understand the technical considerations for its prevention. The existing literature and the results of this case series analysis suggest that removal of the fractured needle fragment should be attempted as soon as possible.
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Affiliation(s)
- Lorena Batista Sandre
- Oral and Maxillofacial Surgery, Hospital de Base Do Distrito Federal, Brasília, DF, Brazil
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2
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Qiu SY, Shan XF, Kang YF, Ding MK, Zhang L, Cai ZG. Accurate occlusion-driven maxillary reconstruction with deep circumflex iliac artery flap using computer-assisted techniques and intraoral anastomosis: a case series study. Int J Oral Maxillofac Surg 2022:S0901-5027(22)00450-7. [DOI: 10.1016/j.ijom.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/21/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
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3
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de Geer A, Brouwer de Koning S, van Alphen M, van der Mierden S, Zuur C, van Leeuwen F, Loeve A, van Veen R, Karakullukcu M. Registration methods for surgical navigation of the mandible: a systematic review. Int J Oral Maxillofac Surg 2022; 51:1318-1329. [DOI: 10.1016/j.ijom.2022.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/18/2021] [Accepted: 01/26/2022] [Indexed: 12/20/2022]
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4
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Seon S, Lee BS, Choi BJ, Ohe JY, Lee JW, Jung J, Hwang BY, Kim MA, Kwon YD. Removal of a suture needle: a case report. Maxillofac Plast Reconstr Surg 2021; 43:22. [PMID: 34224020 PMCID: PMC8257847 DOI: 10.1186/s40902-021-00309-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event. Case presentation In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician. Conclusion CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.
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Affiliation(s)
- Suyun Seon
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Byung-Joon Choi
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Junho Jung
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Bo-Yeon Hwang
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Min-Ah Kim
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea.
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Bessen SY, Wu X, Sramek MT, Shi Y, Pastel D, Halter R, Paydarfar JA. Image-guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery. Head Neck 2021; 43:2534-2553. [PMID: 34032338 DOI: 10.1002/hed.26743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/20/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023] Open
Abstract
Image-guided surgery (IGS) has become a widely adopted technology in otolaryngology. Since its introduction nearly three decades ago, IGS technology has developed rapidly and improved real-time intraoperative visualization for a diverse array of clinical indications. As usability, accessibility, and clinical experiences with IGS increase, its potential applications as an adjunct in many surgical procedures continue to expand. Here, we describe the basic components of IGS and review both the current state and future directions of IGS in otolaryngology, with attention to current challenges to its application in surgery of the nonrigid upper aerodigestive tract.
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Affiliation(s)
- Sarah Y Bessen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Xiaotian Wu
- Massachussetts General Hospital, Boston, Massachusetts, USA
| | - Michael T Sramek
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Yuan Shi
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA
| | - David Pastel
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Department of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Ryan Halter
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA
| | - Joseph A Paydarfar
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA.,Department of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Anand M, Panwar S. Role of Navigation in Oral and Maxillofacial Surgery: A Surgeon's Perspectives. Clin Cosmet Investig Dent 2021; 13:127-139. [PMID: 33883948 PMCID: PMC8055371 DOI: 10.2147/ccide.s299249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/06/2021] [Indexed: 12/21/2022] Open
Abstract
Surgeries related to the maxillofacial area deal with an intricate network of anatomical structures. With the complexity of the vital structures, it necessitates a surgical team to respect each anatomical boundary. In the past, there was an exceptionally high number of cases with surgical errors. These errors were not because of flaws in the surgeon’s skills or techniques but owing to lack of resources. Visualisation is one of the key factors that determines the precision of any surgical outcome. Advances in surgical planning have led to the introduction of a “Navigation” system that helps surgeons to see more, know more and ultimately do more for their patients. The usefulness of the navigation system in oral surgeries has been indicated by its surgical applications in craniomaxillofacial trauma, orthognathic surgeries, head and neck pathological resections, complex skull base surgeries and surgery involving temporomandibular joint. A vast majority of research literature has suggested remarkable improvement in surgical outcomes under the guidance of 3d planning and navigation. However, with such an inordinate advancement, financial expenses and a gradual learning curve are always a constraining factor in surgical navigation. This article overviews indication of navigation in craniofacial surgeries with a focus on applied aspect, planning and solution to the future problem.
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Affiliation(s)
- Manish Anand
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - Shreya Panwar
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
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Monteiro MADO, Antunes ANDG, Basting RT. Physical, chemical, mechanical, and micromorphological characterization of dental needles. J Dent Anesth Pain Med 2021; 21:139-153. [PMID: 33880407 PMCID: PMC8039161 DOI: 10.17245/jdapm.2021.21.2.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background In anesthetic techniques, touching bones can cause needle bending. Theoretically, a needle should support such deflection without fracturing. However, it is possible that a needle may fracture depending on the quality and type of needle used. This study evaluated the physical, chemical, and micromorphological characteristics of long and short dental anesthetic needles, as well as the mechanical properties of flexural load and bending resistance when needles are subjected to different bending angles. Methods Long and short needles (30G, Jets, Misawa, Selekto, Terumo, Unoject and 27G, Dencojet, Injex, Jets, Misawa, Procare, Setoject XL, Terumo) were evaluated. Scanning electron microscopy was used to evaluate the needle bevels and energy-dispersive X-ray spectroscopy was used for the chemical analysis of needle compositions. Flexural loading and bending strength assessments were performed using a universal testing machine by bending the needles (n = 5) to angles of 30°, 60°, or 90°, or until fracture occurred. Results The Injex 27G, Jets 27G, and Septoject XL 27G needles were all less than 30 mm in length. There were small percentage variations in the chemical compositions of the needles. Superior smoothness was observed for the Unoject 30G needle, which exhibited the highest fracture resistance at 60°. The Jets 30G needle exhibited greater resistance to fractures at 90°. The Procare 27G needle exhibited the highest load resistance to bending, followed by the Septoject XL 27G needle, and both needles were tied for the lowest fracture resistance. No needle fractured when bent to 30° or at less than three bends to 60° or 90°. Conclusions Greater needle resistance to bending increases the probability of early fracturing. Thinner and shorter needles are more resistant than longer and thicker needles. Performing a single bend does not result in any significant risk of fracture or obliterate the lumen, allowing for the continued passage of anesthetic liquid.
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Chen KJ, Lo WF, Chen I, Chen MYC. Clinical application of a surgical navigation system for the retrieval of fractured dental needles. Br J Oral Maxillofac Surg 2020; 59:256-257. [PMID: 33461821 DOI: 10.1016/j.bjoms.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- K J Chen
- Division of Oral & Maxillofacial Surgery, Dental Department, China Medical University Hospital, Taichung, Taiwan.
| | - W F Lo
- Division of Oral & Maxillofacial Surgery, Dental Department, China Medical University Hospital, Taichung, Taiwan.
| | - I Chen
- Division of Oral & Maxillofacial Surgery, Dental Department, China Medical University Hospital, Taichung, Taiwan.
| | - M Y C Chen
- Division of Oral & Maxillofacial Surgery, Dental Department, China Medical University Hospital, Taichung, Taiwan; College of Dentistry, China Medical University, Taichung, Taiwan.
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Lukas D, Jan M, Constantinus P, Paul L. Fractured Needle Removal With a 3-Dimensionally Printed Surgical Guide: A Case Report and Literature Review. J Oral Maxillofac Surg 2020; 79:1019-1024. [PMID: 33271183 DOI: 10.1016/j.joms.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Abstract
Needle breakage is a rare complication of inferior alveolar nerve block anesthesia. This study proposes a new localization technique. We used a three-dimensionally printed surgical guide, supported by the lower dental arch to minimize the required surgical access. With this approach, the procedure could be performed with procedural sedation anesthesia.
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Affiliation(s)
- Driesen Lukas
- Medical Student, Department of OMFS, University Hospitals Leuven, Leuven, Belgium
| | - Meeus Jan
- Resident, Department of OMFS, University Hospitals Leuven, Leuven, Belgium
| | | | - Legrand Paul
- Visiting Professor, Department of OMFS, University Hospitals Leuven, Leuven, Belgium.
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Jamil FA, Asmael HM, Al-Jarsha MY. The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study. BMC Oral Health 2020; 20:239. [PMID: 32867733 PMCID: PMC7457358 DOI: 10.1186/s12903-020-01228-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block. METHODS Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local injection was given lingually. All operations were started at approximately 5 min after the buccal injection. The collected data included age, gender, pain perception and its intensity during treatment at three checkpoints, apical tenderness, and the type of extraction. Any associated complications or difficulties were also recorded. Then the results were analyzed and interpreted using appropriate statistical tests. The significance level was set at P ≤ 0.05. RESULTS A total of 247 cases (1st premolar, n = 119; 2nd premolar, n = 128), predominantly male, were included. In 95% of study sample, the patients were satisfied with the dental extraction without any pain. However, in 5% of cases, pain was reported at the stage of tooth removal. Apical tenderness was found to be present in 11% of the total cases. Three teeth required surgical removal. Upon analysis, no significant differences in the success rates were detected between the 2 premolar groups or amongst the various age groups. Minor and transient side effects were reported in this study. CONCLUSION The technique is simple and effective as well. It might be considered as an alternative anesthetic injection to the inferior alveolar nerve block for dental extraction of the mandibular premolars.
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Affiliation(s)
- Firas A Jamil
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq.
| | - Huda Moutaz Asmael
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq
| | - Mohammed Yahya Al-Jarsha
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq
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Margolis A, Loparich A, Raz E, Fleisher KE. Use of Intraoperative Biplanar Fluoroscopy for Minimally Invasive Retrieval of a Broken Dental Needle. J Oral Maxillofac Surg 2020; 78:1922-1925. [PMID: 32768404 DOI: 10.1016/j.joms.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/27/2022]
Abstract
This report describes a case of needle breakage during a left-sided inferior alveolar nerve block to perform restorative dentistry on a 56-year-old male patient. The needle was removed in conjunction with interventional neuroradiology using biplanar fluoroscopy.
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Affiliation(s)
- Alexander Margolis
- Resident, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, Bellevue Hospital, NYU Langone Health, New York, NY.
| | - Alyssa Loparich
- Resident, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, Bellevue Hospital, NYU Langone Health, New York, NY
| | - Eytan Raz
- Assistant Professor Radiology, NYU Langone Health, New York, NY
| | - Kenneth E Fleisher
- Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, Bellevue Hospital, NYU Langone Health, New York, NY
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Yao J, Zeng W, Zhou S, Cheng J, Huang C, Tang W. Augmented Reality Technology Could Be an Alternative Method to Treat Craniomaxillofacial Foreign Bodies: A Comparative Study Between Augmented Reality Technology and Navigation Technology. J Oral Maxillofac Surg 2020; 78:578-587. [DOI: 10.1016/j.joms.2019.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/06/2019] [Accepted: 11/10/2019] [Indexed: 12/11/2022]
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Abstract
Dynamic navigation (DN) has been used by many fields previously and recently applied to dental implant surgery. DN allows the implant surgeon to evaluate a patient, scan the patient, plan the implant position, and perform the implant surgery in the same day without the delay or cost of fabrication of a static surgical guide stent. The current DN workflow requires (1) cone-beam computed tomography with fiducials, (2) virtual implant planning, (3) calibration, and (4) implant placement in accordance to the 3-D image on the navigation screen. This technology allows for improved precision and accuracy in the placement of dental implants.
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Computerized Navigation for Minimal Invasive Retrieval of Displaced Dental Implants in the Lower Jaw. Oral Maxillofac Surg Clin North Am 2019; 31:447-455. [DOI: 10.1016/j.coms.2019.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Wang H, Yang CY, Li Z. Traumatic displacement of teeth into maxillary sinus and the retrieval assisted by computer-assisted navigation: A case report. Medicine (Baltimore) 2018; 97:e13865. [PMID: 30572558 PMCID: PMC6320084 DOI: 10.1097/md.0000000000013865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Traumatic displacement of teeth into the maxillary sinus is rare. This report described a case of 2 molars accidentally displaced into the maxillary sinus and the retrieval of teeth assisted by computer-assisted navigation. PATIENT CONCERN A 16-year-old male patient suffered from maxillofacial trauma with the first and second molars in the left maxilla were missing, and an orificium fistula to the maxillary sinus appeared in the dentition region of molars. DIAGNOSE The tomography revealed 2 tooth-like hyperdensity images in the left maxillary sinus. INTERVENTION Computer-assisted navigation surgery was scheduled for the retrieval surgery, and the displaced teeth were removed from the maxillary sinus smoothly. OUTCOMES The patient displayed uneventful wound healing without postoperative complications in the maxillary sinus. LESSONS Surgeons should be alert to the presence of missing teeth in maxillofacial trauma and avoid missed diagnosis, and computer-assisted navigation is recommended for the retrieval of teeth displaced into the maxillary sinus.
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Affiliation(s)
- Hang Wang
- Department of Oral and Maxillofacial Surgery
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chan-Yuan Yang
- Department of Oral and Maxillofacial Surgery
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhi Li
- Department of Oral and Maxillofacial Surgery
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Kuzin AV, Gurin AN, Shcherbakov AM. [Needle fractures during mandibular block: prevention and emergency care algorithm]. STOMATOLOGII︠A︡ 2018; 97:56-59. [PMID: 29992941 DOI: 10.17116/stomat201897356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cases of dental needle fracture during mandibular block were studied in the last 10 years. Despite dental anesthesia development, the cases of needle fracture occur regularly in the world practice. Some of these complications has iatrogenic nature while others may be attributed to independent reasons like patients' sharp movement and needle manufacturing defect. In most of the cases the needle migrates to surrounding anatomical spaces making operative removing a challenging task. Subsequent surgical removing of a foreign body has severe consequences to patient in the form of a large operating injury, long-term disability and functional limitations. The article presents an algorithm for prevention and emergency care for a patient with dental needle fracture during mandibular block.
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Affiliation(s)
- A V Kuzin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A N Gurin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Acham S, Truschnegg A, Rugani P, Kirnbauer B, Reinbacher KE, Zemann W, Kqiku L, Jakse N. Needle fracture as a complication of dental local anesthesia: recommendations for prevention and a comprehensive treatment algorithm based on literature from the past four decades. Clin Oral Investig 2018; 23:1109-1119. [DOI: 10.1007/s00784-018-2525-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/11/2018] [Indexed: 02/06/2023]
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Minimally-invasive removal of a screw in the mandibular condyle using computer-assisted navigation. Br J Oral Maxillofac Surg 2017; 55:865-867. [PMID: 28735638 DOI: 10.1016/j.bjoms.2017.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/27/2017] [Indexed: 11/20/2022]
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Yang CY, Yang RT, He SG, Li Z. Removal of a large number of foreign bodies in the maxillofacial region with navigation system. Dent Traumatol 2017; 33:230-234. [PMID: 27926993 DOI: 10.1111/edt.12313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Chan-Yuan Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST); Wuhan University; Wuhan China
- Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Rong-Tao Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST); Wuhan University; Wuhan China
- Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - San-Gang He
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST); Wuhan University; Wuhan China
- Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Zhi Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST); Wuhan University; Wuhan China
- Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
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Sukegawa S, Kanno T, Shibata A, Matsumoto K, Sukegawa-Takahashi Y, Sakaida K, Furuki Y. Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report. J Med Case Rep 2017; 11:14. [PMID: 28088226 PMCID: PMC5237551 DOI: 10.1186/s13256-016-1182-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/18/2016] [Indexed: 11/21/2022] Open
Abstract
Background A fracture of root canal instruments, with a fractured piece protruding beyond the apex, is a troublesome incident during an endodontic treatment. Locating and retrieving them represents a challenge to maxillofacial surgeons because it is difficult to access due to the proximity between the foreign body and vital structures. Although safe and accurate for surgery, radiographs and electromagnetic devices do not provide a precise three-dimensional position. In contrast, computer-aided navigation provides a correlation between preoperatively collected data and intraoperatively encountered anatomy. However, using a navigation system for mandible treatment is difficult as the mobile nature of the mandible complicates its synchronization with the preoperative imaging data during surgery. Case presentation This report describes a case of a dental instrument breakage in the mandible during an endodontic treatment for a restorative dental procedure in a 65-year-old Japanese woman. The broken dental instrument was removed using a minimally invasive approach with a surgical navigation system and an interocclusal splint for a stable, identically repeatable positioning of the mandible. Using the three-dimensional position of the navigation probe, a location that best approximated the most anterior extent of the fragment was selected. A minimally invasive vestibular incision was made at this location, a subperiosteal reflection was performed, and the foreign body location was confirmed using a careful navigation system. The instrument was carefully visualized and extruded from the apical to the tooth crown side and was then removed using mosquito forceps through the medullary cavity of the crown side of the tooth. Follow-up was uneventful; her clinical course was good. Conclusions The use of a surgical navigation system together with an interocclusal splint enabled the retrieval of a broken dental instrument in a safe and minimally invasive manner without damaging the surrounding vital structures.
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Affiliation(s)
- Shintaro Sukegawa
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan.
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Akane Shibata
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Kenichi Matsumoto
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Yuka Sukegawa-Takahashi
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Kyosuke Sakaida
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Yoshihiko Furuki
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
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A novel case of a broken dental anesthetic needle transecting the right internal carotid artery. J Am Dent Assoc 2016; 147:739-42. [PMID: 27087052 DOI: 10.1016/j.adaj.2016.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OVERVIEW Although dental anesthetic needle fractures remain an uncommon occurrence, there is a lack of consensus on the management of the treatment of this complication. Complications could include trismus, dysphagia, or infection that may lead to more deleterious results. CASE DESCRIPTION In this case study, a 47-year-old man underwent a routine dental extraction at a private office. During administration of the inferior alveolar nerve block, a dental anesthetic needle fractured. The general dental practitioner dismissed the patient and reassured him that no retrieval of the needle was needed. Several weeks later, the patient sought care for severe, acute pain and dysphagia. Traditional retrieval techniques were unsuccessful, and the authors consulted the neurosurgery team. The patient underwent endovascular surgery with digital subtraction angiography for retrieval of the needle from the right internal carotid artery. CONCLUSIONS AND PRACTICAL IMPLICATIONS Most authors in the literature agree that proper technique and equipment are paramount in avoiding fractures of dental anesthetic needles. Although needle fracture is a rare complication, immediate referral and retrieval of the broken needle by an appropriately trained surgeon is essential for optimal outcomes. This case demonstrates an example of a broken needle that migrated and transected the internal carotid artery at the jugular foramen. All dental practitioners must be cognizant of the potentially serious complications associated with a retained broken needle.
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Stein KM. Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle. J Oral Maxillofac Surg 2015; 73:1911-6. [PMID: 25981862 DOI: 10.1016/j.joms.2015.04.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 11/25/2022]
Abstract
This report describes a case of needle breakage during an inferior alveolar nerve block to perform a restorative dental procedure on a 13-year-old patient. The needle was removed in a minimally invasive fashion using a Medtronic StealthStation S7 surgical navigation system and custom interocclusal splint to allow for stable, identically repeatable positioning of the mandible. This report adds another example of the utility of image-guided surgery for the removal of foreign bodies from the head and neck region in a minimally invasive fashion.
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Affiliation(s)
- Kyle M Stein
- Clinical Assistant Professor, Division of Oral and Maxillofacial Surgery, Hospital Dentistry Institute, The University of Iowa Hospitals and Clinics, Iowa City, IA.
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Li P, Li Z, Tian W, Tang W. A strategy for removal of foreign body in mandible with navigation system. Int J Oral Maxillofac Surg 2015; 44:885-8. [PMID: 25744644 DOI: 10.1016/j.ijom.2015.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 11/02/2014] [Accepted: 01/27/2015] [Indexed: 11/15/2022]
Abstract
Navigation surgery in the mandible has rarely been reported because of the complexities of navigating a mobile structure. In this article, we present a simple and novel strategy for removal of a foreign body in the mandible using a navigation system. A female diagnosed with a foreign body in the left mandible underwent navigation surgery using a BrainLAB system. We used a special open splint fabricated with acrylic resin to successfully perform the mandibular navigation. This strategy may be appropriate for many types of mandibular navigation surgery.
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Affiliation(s)
- P Li
- College of computer science, Sichuan University, Chengdu, China
| | - Z Li
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, China
| | - W Tian
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, China
| | - W Tang
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, China.
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Lee TYT, Zaid WS. Broken dental needle retrieval using a surgical navigation system: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:e55-9. [PMID: 25442246 DOI: 10.1016/j.oooo.2014.08.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/11/2014] [Accepted: 08/25/2014] [Indexed: 11/30/2022]
Abstract
This paper reports a case of fractured needle retrieval in the pterygomandibular space using the Medtronic surgical navigation system. Current literature on needle fracture and retrieval in the oral cavity was also reviewed. A literature search was conducted in the following databases: PubMed, MDConsult, The Cochrane Library, and Google. A variety of keywords were used, including "needle fracture," "broken dental needle," "needle injuries in dentistry," "foreign body retrieval," and "dental needle retrieval." Articles published after 1980 were reviewed. Seventeen articles that involved broken dental needle retrieval were selected.
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Affiliation(s)
- Tim Yen Ting Lee
- Resident, Department of Oral and Maxillofacial Surgery, Louisiana State University School of Dentistry, New Orleans, LA, USA.
| | - Waleed Suliman Zaid
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University School of Dentistry, New Orleans, LA, USA
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Gerbino G, Zavattero E, Berrone M, Berrone S. Letter to the editor. J Oral Maxillofac Surg 2014; 72:653-4. [PMID: 24480776 DOI: 10.1016/j.joms.2013.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 12/25/2013] [Indexed: 10/25/2022]
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Philbert R, Hamilton B, Zola M. Management of needle breakage using intraoperative navigation following inferior nerve block. J Oral Maxillofac Surg 2014; 72:653. [PMID: 24468020 DOI: 10.1016/j.joms.2013.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 11/16/2022]
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