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Wadhwani CPK, Hess TA, Schoenbaum TR, Wadhwani YH, Chung KH. Dentists' Perspective and Experiences Relative to the Accidental Dropping of Implant Drivers and Components Intraorally: A Survey of Practicing Clinicians. J ORAL IMPLANTOL 2024; 50:39-44. [PMID: 38579111 DOI: 10.1563/aaid-joi-d-22-00215] [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] [Indexed: 04/07/2024]
Abstract
Ingestion or aspiration of dental implant screwdrivers or implant components is potentially life-threatening. There are no reports on the frequency at which dentists drop these devices within the mouth or which components are most problematic. There are few reports on what protective measures clinicians take, where risks exist, and how this problem is managed. A 9-part questionnaire was provided to dentists. Data collected included clinicians' roles, implant surgeons, restorative clinicians, or both-the frequency of dropping implant screwdrivers or components, items considered most problematic. Patient protection and management were also requested. Finally, questions related to how much of a problem clinicians considered this to be and if further solutions and a standardized management protocol should be developed. One hundred twelve dentists voluntarily completed the survey. Of the dentists, 54% restored, 37% restored and surgically placed, and 9% solely placed implants. Twenty-nine percent claimed never to drop components, with 56% dropping an instrument less than 10% of the time. Less than half would suggest patients seek medical advice if a screwdriver or component was accidentally dropped intraorally and was not recovered. Thirty percent never tied floss tethers to screwdrivers, and a similar percentage reported they only sometimes did so. Throat pack protection was reported 51% of the time. Ninety percent considered dropping components an issue, with screwdrivers most problematic. Aspiration or ingestion of implant screwdrivers and components is problematic, with dentists varying their use of protection devices. There is a need to standardize and implement patient protection procedures and management and develop methods to reduce the risk of these potentially life-threatening issues.
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Affiliation(s)
- Chandur P K Wadhwani
- Private practice limited to prosthodontics, Bellevue, WA, USA
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA
| | - Timothy A Hess
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA
- Private practice, Auburn, WA, USA
| | | | - Yasmin H Wadhwani
- Department of Neurobiology, Physiology and Behavioral Sciences, University of California, Davis, Davis, CA, USA
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA
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Healing Abutment Distortion in Implant Prostheses: An In Vitro Study. J Funct Biomater 2022; 13:jfb13030085. [PMID: 35893453 PMCID: PMC9326645 DOI: 10.3390/jfb13030085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/04/2022] Open
Abstract
Little has been studied regarding the repeated usage of healing abutments and their effects on the distortion of dental implant-healing abutment hex surfaces. Additionally, implant manufacturers do not provide specific guidelines on how many times a healing abutment can be used before discarding. Therefore, we evaluated the effect of repeated screwing-unscrewing of implant-healing abutment on the healing abutment hex surface and screw head. A total of 12 Biomate implants with 4 mm diameter and 13 mm length were inserted into a synthetic bone block. The standard healing abutments of 3 mm diameter and 4 mm length were screwed onto each implant using a torque ratchet at a final torque of 30 Ncm. Immediately, the abutments were unscrewed at 30 Ncm. Then, screwing-unscrewing was repeated for 4, 8, 16, 24, 32, 40, 80, 160, 320, and 400 times and the healing abutments were scanned under the scanning electron microscope for any distortion. Distortion was graded as 0, 1, 2, and 3. Data were analyzed using SPSS 24.0. Descriptive statistics were calculated. One-way ANOVA with post hoc using Tukey’s HSD test was performed to analyze the difference in distortion at different screwing-unscrewing times. A significant level was selected at p-value = 0.05. It was found that distortion healing abutments screws were seen after 32 times screwing and unscrewing. There was a significant difference in the distortion (p-value < 0.05) after 24 times of repeated usage of healing abutment and at 160, 320, and 400 times. No surface distortions were observed at the healing abutment screw head at 4, 8, 16, 24, 32, 40, 80, 160, 320, and 400 cycles of screwing-unscrewing. It can be concluded that repeated screwing and unscrewing of the implant-healing abutments causes damage to the healing abutment hex surface. The distortion of healing abutments screws was seen after 32 times screwing and unscrewing. No surface distortions were observed on the healing abutment screw head until 400 times of screwing and unscrewing. Hence, the clinician should be cautious while using the healing abutments repeatedly.
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KENÇ S, IŞIK G, GÜNBAY T, KAHRAMAN S, ÇELİK F. Implant screwdriver aspiration during dental procedure at a geriatric patient: a case report. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1086254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Aspiration of dental items: Case report with literature review and proposed management algorithm. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:452-458. [PMID: 34687948 DOI: 10.1016/j.jormas.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/29/2021] [Accepted: 10/14/2021] [Indexed: 01/15/2023]
Abstract
The aim of this present study is to describe a case of a screwdriver implant aspiration removed with flexible bronchoscopy. This study reviewed the current literature and the authors also proposed an airway management algorithm in case of suspected foreign body aspiration during dental procedures. A review of English-language literature of aspiration of objects after clinical dental practice from 1984 to 2021 was performed. The bronchoscopy was the main method for dental items removal. A total of 57 cases from the literature were enrolled in this study. Aspiration of dental crown and prostheses (43.85%) followed by implant material (19.29%) and tooth (15.78%) were the main aspirated items. Prevention is the better way to avoid this type of complication. Early diagnosis facilitates the removal of foreign body and bronchoscopy is considered the treatment of choice for removal of foreign body aspiration. Also, regular professional training in basic life support is required.
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Liu Y, Lin Y, Di P. A modified implant abutment holder fabricated with fused deposition modeling to improve the transfer process for implant-supported restorations. J Prosthet Dent 2020; 125:411-414. [PMID: 32248997 DOI: 10.1016/j.prosdent.2020.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 10/24/2022]
Abstract
Ingestion or aspiration of an implant abutment can occur in patients during the process of abutment transfer for implant-supported restorations, especially in the posterior region. A technique of fabricating an abutment holder is described to prevent ingestion or aspiration by computer-aided design (CAD) and fused deposition modeling (FDM). The modified abutment holder has a serrated handle for a firm grip and a barrel-shaped fixed portion that firmly secures the abutment. The modified holder is more secure than the conventional hexagon screwdriver. Furthermore, abutment holders can be easily manufactured by using 3D printers and repeatedly used for multiple implants restoration without substitution.
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Affiliation(s)
- Yanping Liu
- PhD candidate, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ye Lin
- Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ping Di
- Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China.
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Screwdriver Aspiration During Oral Procedures: A Lesson for Dentists and Gastroenterologists. PROSTHESIS 2019. [DOI: 10.3390/prosthesis1010008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This article reports the case of a patient suffering from Alzheimer’s disease who underwent a dental procedure for the peri-implantitis of his dental implants placed some years earlier. Our aim was to describe a misinterpreted accidental foreign body aspiration and its management. Due to an involuntary movement, the patient accidentally ingested a screwdriver, so, although asymptomatic, he was taken to the hospital. Based on the radiographic interpretation, the radiologists diagnosed the presence of the object in the distal esophagus; an esophagogastroduodenoscopy was performed but the screwdriver was not found. Subsequently, a computed tomography (CT) scan was performed which placed the foreign body in the airways and it was successfully removed by bronchoscopy. Patients with dementia need additional care during dental procedures because of the increased risk of ingestion and/or aspiration. We demonstrated how important it is, even without any symptoms, the need to be vigilant in seeking out urgent care as soon as possible.
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Hou R, Zhou H, Hu K, Ding Y, Yang X, Xu G, Xue P, Shan C, Jia S, Ma Y. Thorough documentation of the accidental aspiration and ingestion of foreign objects during dental procedure is necessary: review and analysis of 617 cases. Head Face Med 2016; 12:23. [PMID: 27449659 PMCID: PMC4957346 DOI: 10.1186/s13005-016-0120-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/12/2016] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To review the cases of accidental aspiration and ingestion of foreign objects during dental procedure, and to emphasize the importance of thorough documentation of the accidents. METHODS A comprehensive search on (dental procedure/treatment/practice), (aspiration/inhalation), and (ingestion/swallow) was performed for all years before 1st October 2014 available. The statistic analysis was made on the variables including journals and reported year, patients' age, gender, general conditions, dental procedure and location for procedure, foreign objects, site of involvement, possible causes, anesthesia during procedure and treatment, symptoms, treatment time and treatment modality, follow-up, and so on. RESULTS A total of 617 cases reported by 45 articles from 37 kinds of journals were included and analyzed. Most reports made detailed record. While some important variables were recorded incompletely, including patient's general conditions, location for procedure, clinical experience of the involving dentists, tooth position of procedure, possible causes, and anesthesia during procedure and treatment for the accident. CONCLUSIONS Aspiration and ingestion of foreign objects are rare and risky complication during dental procedure. Each accident should have thorough documentation so as to provide enough information for the treatment and prevention.
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Affiliation(s)
- Rui Hou
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Hongzhi Zhou
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Kaijin Hu
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Yuxiang Ding
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Xia Yang
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Guangjie Xu
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Peng Xue
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Chun Shan
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Sen Jia
- />Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an City, Shaanxi Province 710032 China
| | - Yuanyuan Ma
- />Department of Stomatology, Research Institute of Surgery & Daping Hospital, The Third Military Medical University, Chongqing City, 400042 China
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