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Smith T, Blum R, Rozdolski R. Management of an Ingested Foreign Body in a COVID-Positive Patient. Anesth Prog 2023; 70:178-183. [PMID: 38221701 PMCID: PMC11088193 DOI: 10.2344/anpr-70-03-03] [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: 09/21/2022] [Accepted: 05/09/2023] [Indexed: 01/16/2024] Open
Abstract
This case report describes a 51-year-old man who swallowed an amalgam fragment dislodged during dental treatment performed without a throat screen. The patient was transferred to the emergency department, where the foreign body was confirmed to be in the esophagus following radiographic imaging. Foreign body removal from the esophagus is routinely achieved via esophagogastroduodenoscopy (EGD). However, this incident occurred in September 2020, at the height of the COVID-19 pandemic. Because of the patient's preoperative positive COVID-19 test, the option for EGD retrieval was eliminated per hospital protocol. Instead, a noninvasive approach with serial radiographic monitoring was deemed mandatory to observe the fragment as it passed through the gastrointestinal tract, warranted by the small size of the foreign body and the patient's lack of signs and symptoms of respiratory distress. This case report reinforces the importance of using airway protection during every dental procedure. Furthermore, reevaluation of EGD as the gold standard for treatment of ingested small materials may be warranted.
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Affiliation(s)
- Tiffany Smith
- Touro College of Dental Medicine, Hawthorne, New York
| | - Rachel Blum
- Touro College of Dental Medicine, Hawthorne, New York
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2
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Ptak DM, Alon E, Amato RB, Tassinari J, Velasquez A. Ingestion and surgical retrieval of an endodontic file: a case report. Restor Dent Endod 2023; 48:e32. [PMID: 38053779 PMCID: PMC10695727 DOI: 10.5395/rde.2023.48.e32] [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: 05/15/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 12/07/2023] Open
Abstract
Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide non-surgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.
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Affiliation(s)
- Devon Marta Ptak
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Elinor Alon
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Robert Bruce Amato
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Julia Tassinari
- Brown Surgical Associates, Inc., Newport, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Adrian Velasquez
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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3
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Alevizakos V, Achilles N, Rahlf B, Jehn P, von See C, Schiller M. Comparing Original and Universal Screwdrivers and How They Affect Friction in the Screw. J ORAL IMPLANTOL 2023; 49:532-536. [PMID: 36893110 DOI: 10.1563/aaid-joi-d-20-00249] [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: 08/03/2020] [Revised: 08/05/2021] [Accepted: 09/21/2022] [Indexed: 03/10/2023]
Abstract
The present study focused on investigating whether universal screwdriver kits cause less friction between the screwdriver and the abutment screw than original screwdrivers. For this purpose, 2 original screwdrivers (Straumann and BEGO) and a universal screwdriver kit (bredent) were investigated. On 1 implant per screwdriver, 26 abutments were properly attached one after the other with the corresponding abutment screws. After tightening the abutment screw, the force required to pull the screwdriver off the screw head was determined with a spring balance. For both manufacturers, greater pull-off forces were measured when using the original screwdrivers than when using the universal screwdriver. The pull-off force (mean ± SD) required for the Straumann original screwdriver was 3.7 ± 1.4 N, while that required for the universal screwdriver was 0.1 ± 0.1 N (P < .001). The pull-off force was 1.5 ± 1.5 N for the BEGO original screwdriver and 0.7 ± 0.9 N for the universal screwdriver (P = .19). Using original manufacturer-supplied screwdrivers could thus minimize the risk of the screwdriver slipping out of the screw head during dental treatment and being swallowed or aspirated by the patient.
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Affiliation(s)
- Vasilios Alevizakos
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Nadine Achilles
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Björn Rahlf
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Philipp Jehn
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Constantin von See
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Marcus Schiller
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
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4
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Reis A, Loguercio AD, Favoreto M, Chibinski AC. Some Myths in Dentin Bonding: An Evidence-Based Perspective. J Dent Res 2023; 102:376-382. [PMID: 36707968 DOI: 10.1177/00220345221146714] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Laboratory investigations are essential models responsible for science development. However, laboratory discoveries must be confirmed in a clinical environment where many known and unknown variables and complex mechanisms are involved. Using conclusions from laboratory studies to make clinical recommendations can lead to widespread "unreliable truths" or so-called myths in any field of knowledge. These myths may increase the costs (financial and time) or even cause harm (side effects) that would be unnecessary, given that the current protocol or conduct was previously evaluated in a more complex and complete clinical setting. This article will discuss certain myths in dentin bonding that may influence clinical decision-making, bringing some principles of evidence-based practice to allow a more critical evaluation of the literature findings.
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Affiliation(s)
- A Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - A D Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - M Favoreto
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - A C Chibinski
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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Nagarkar S, Loguercio AD, Perdigão J. Evidence-based fact checking for selective procedures in restorative dentistry. Clin Oral Investig 2023; 27:475-488. [PMID: 36607490 DOI: 10.1007/s00784-022-04832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Similar to other dental specialties, there are many clinical procedures in restorative dentistry that may or may not be supported by good evidence. Thus, the effectiveness of these procedures is uncertain. The aim of this paper is to reduce this knowledge gap by critically inspecting selective procedures in restorative dentistry and exploring if these well-established or widely advocated treatment modalities are necessary for improving treatment outcomes based on the best available evidence. MATERIALS AND METHODS A MEDLINE search was conducted to identify research on selective procedures while focusing on clinical trials and systematic reviews. Due to their practical relevance in the decision-making process, cost-effectiveness analyses were also included. RESULTS Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them while others were mostly based on beliefs. CONCLUSIONS A critical review of the available literature indicates that some common restorative procedures lack adequate support from high-quality research evidence. CLINICAL RELEVANCE This paper attempts to highlight the need to critically examine the scientific validity of traditional knowledge and techniques through the context of current research evidence. This will not only help generate consensus between educators, clinicians, and researchers regarding restorative procedures but will also lead to improved patient care and outcomes.
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Affiliation(s)
- Sanket Nagarkar
- Park Dental Group, Minneapolis, MN, USA.,Department of Restorative Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, 515 SE Delaware St, 8-450 Moos Tower, Minneapolis, MN, 55455, USA.
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6
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Alkhatib OA, Bissasu S, Daud A. Dental floss ties for rubber dam isolation: A proposed classification and a new technique. J Prosthodont 2023; 32:83-89. [PMID: 36263955 PMCID: PMC10092548 DOI: 10.1111/jopr.13611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/01/2022] [Indexed: 01/26/2023] Open
Abstract
Rubber dam application has become an essential part of restorative dentistry. In late 2019, dentistry faced a new challenge with the COVID-19 pandemic and therefore, the implementation of extra isolation methods became crucial. This article introduces a classification of dental floss ties used with a rubber dam, including the "simple" ties that are subdivided into traditional ties, single-loop self-ligating ties and double-loop self-ligating ties, and a new state-of-the-art design. The "compound tie" design incorporates a combination of one or more subdivisions of the simple ties. This new design may provide better isolation and more consistent gingival tissue retraction. Furthermore, due to the advanced technique applied, the tie will offer improved stability and prevent the sheet from sliding over the dental floss tie from all surfaces.
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Affiliation(s)
- Osama A Alkhatib
- Department of Fixed Prosthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Sami Bissasu
- Restorative Department, Dental Institute, Queen Mary University of London, London, UK
| | - Alaa Daud
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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7
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Naderian A, Baghaie H, Satchithanandha V. Accidental ingestion of an endodontic file: a case report. J Med Case Rep 2022; 16:151. [PMID: 35418307 PMCID: PMC9008955 DOI: 10.1186/s13256-022-03363-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/04/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Ingestion of dental instruments is rare during dental surgery but can result in serious complications. Here we describe a case in which an endodontic hand file was accidentally misplaced in situ during endodontic (root canal) therapy. Plain radiographs were used to identify its location, and serial imaging was used to monitor passage of the endodontic file through the gastrointestinal tract, and it ultimately passed without intervention. We conclude by describing methods for surveillance and management of ingested dental instruments. CASE REPORT A 62-year-old Caucasian male presented to the Emergency Department approximately 2 hours after suspected ingestion or inhalation of an endodontic hand file. He had experienced two episodes of excessive coughing and dyspnea while undergoing endodontic therapy, and was promptly referred by his dentist for further investigation. On admission, plain abdominal radiographs confirmed the position of the file in the duodenum, and serial radiographs were used to monitor its transition and clearance through the gastrointestinal tract. During this time, the patient did not demonstrate any clinical signs of bowel perforation, nor was there any radiographic evidence of pneumoperitonium. The patient was discharged after a final radiograph confirmed the absence of the foreign body. CONCLUSION Ingestion and inhalation of dental instruments can be life threatening and should be managed cautiously, with early input from general surgeons, gastroenterologists, or respiratory physicians for possible endoscopic retrieval, emergent laparotomy, or surgical intervention. Imaging studies are useful for discerning the position of the foreign body and to determine whether retrieval is possible, and the management will ultimately depend on the position and characteristics of the foreign body, as well as risk factors from the patient which may increase the likelihood of perforation, obstruction, or impaction.
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Affiliation(s)
- Ashkun Naderian
- Royal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia.
| | - Hooman Baghaie
- Royal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia
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Çağlayan F, Yozgat İlbaş FN. Sonographic features of various dental materials and foreign bodies. Dentomaxillofac Radiol 2022; 51:20210182. [PMID: 34347525 PMCID: PMC8802696 DOI: 10.1259/dmfr.20210182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To reveal the sonographic characteristics of various foreign bodies and dental materials to aid diagnosis. METHODS AND MATERIALS 24 objects consisting of various dental materials and foreign bodies were included in the study. Objects were embedded in bovine gelatin. Images of the objects were obtained by conventional radiography and ultrasonography (USG). Opacities were evaluated by conventional radiography. Their visibility and posterior acoustic behaviors were examined by USG. In addition, the actual sizes of the objects and their dimensions measured by USG were compared. RESULTS All objects included in the study, including non-opaque ones, could be visualized by USG. When the posterior acoustic behavior of objects was examined, 15 of the objects (62.5%) caused posterior acoustic shadowing on USG. While 6 of the objects (25%) did not have any USG artifacts, 2 of them (8,3%) had comet tail artifact and 1 of them (4,2%) had reverberation artifact. There was no statistically significant difference between the actual dimensions of the objects and their dimensions measured by USG (p > 0,05). CONCLUSION USG is a very useful technique for imaging foreign bodies and dental materials, it can even show objects that cannot be seen in X-rays on in-vitro environment.
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Affiliation(s)
- Fatma Çağlayan
- Department of Oral Dental and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Fatma Nur Yozgat İlbaş
- Department of Oral Dental and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
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9
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Huh J, Lee N, Kim KY, Jung S, Cha J, Kim KD, Park W. Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study. J Dent Anesth Pain Med 2022; 22:187-195. [PMID: 35693354 PMCID: PMC9171336 DOI: 10.17245/jdapm.2022.22.3.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients’ age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients’ sex, age, and dental department were statistically identified. Results There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig’s disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.
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Affiliation(s)
- Jisun Huh
- Department of Dental Education, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Namkwon Lee
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ki-Yeol Kim
- Department of Dental Education, BK21 PLUS project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Seoyeon Jung
- Department of Dental Education, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jungyul Cha
- Department of Orthodontics, The Institute of Craniofacial Deformity, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Wonse Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
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10
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Huh JY. Foreign body aspirations in dental clinics: a narrative review. J Dent Anesth Pain Med 2022; 22:161-174. [PMID: 35693357 PMCID: PMC9171332 DOI: 10.17245/jdapm.2022.22.3.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.
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Affiliation(s)
- Jin-Young Huh
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine, Gwang-Myeong, Republic of Korea
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11
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Amini H, Boynton JR. Aspiration of an exfoliated primary molar in a child with cerebral palsy: A case report. SPECIAL CARE IN DENTISTRY 2021; 42:416-420. [PMID: 34874069 DOI: 10.1111/scd.12686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/07/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Abstract
Foreign body aspiration is a concern in children which may occur with anything introduced to the oral cavity and can result in significant morbidity and mortality. Food and foreign objects are the most commonly aspirated objects in young children. Aspiration of a normally exfoliated primary tooth is thought to be extremely rare, if not unheard-of. The purpose of this case report is to describe the events occurring to a 10-year-old child with a cerebral palsy presenting with signs and symptoms of respiratory distress due to aspiration of a naturally exfoliated primary molar. Recommendations are provided for delivery of appropriate anticipatory guidance, management of exfoliating primary teeth, and safe clinical practice.
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Affiliation(s)
- Homa Amini
- Division of Pediatric Dentistry, Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - James R Boynton
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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12
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Tokede O, Walji M, Ramoni R, Rindal DB, Worley D, Hebballi N, Kumar K, van Strien C, Chen M, Navat-Pelli S, Liu H, Etolue J, Yansane A, Obadan-Udoh E, Easterday C, Enstad C, Kane S, Rush W, Kalenderian E. Quantifying Dental Office-Originating Adverse Events: The Dental Practice Study Methods. J Patient Saf 2021; 17:e1080-e1087. [PMID: 29206706 PMCID: PMC10941983 DOI: 10.1097/pts.0000000000000444] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preventable medical errors in hospital settings are the third leading cause of deaths in the United States. However, less is known about harm that occurs in patients in outpatient settings, where the majority of care is delivered. We do not know the likelihood that a patient sitting in a dentist chair will experience harm. Additionally, we do not know if patients of certain race, age, sex, or socioeconomic status disproportionately experience iatrogenic harm. METHODS We initiated the Dental Practice Study (DPS) with the aim of determining the frequency and types of adverse events (AEs) that occur in dentistry on the basis of retrospective chart audit. This article discusses the 6-month pilot phase of the DPS during which we explored the feasibility and efficiency of our multistaged review process to detect AEs. RESULTS At sites 1, 2, and 3, respectively, 2 reviewers abstracted 21, 11, and 23 probable AEs, respectively, from the 100 patient charts audited per site. At site 2, a third reviewer audited the same 100 charts and found only 1 additional probable AE. Of the total 56 probable AEs (from 300 charts), the expert panel confirmed 9 AE cases. This equals 3 AEs per 100 patients per year. Patients who experienced an AE tended to be male and older and to have undergone more procedures within the study year. CONCLUSIONS This article presents an overview of the DPS. It describes the methods used and summarizes the results of its pilot phase. To minimize threats to dental patient safety, a starting point is to understand their basic epidemiology, both in terms of their frequency and the extent to which they affect different populations.
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Affiliation(s)
- Oluwabunmi Tokede
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Muhammad Walji
- School of Dentistry, University of Texas at Houston, Health Science Center, Houston, Texas
| | - Rachel Ramoni
- Office of Research & Development, US Department of Veterans Affairs, Washington, District of Columbia
| | | | | | - Nutan Hebballi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Krishna Kumar
- School of Dentistry, University of Texas at Houston, Health Science Center, Houston, Texas
| | - Claire van Strien
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Mengxia Chen
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Shaked Navat-Pelli
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Hongchun Liu
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Jini Etolue
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston Massachusetts
| | - Alfa Yansane
- Department of Preventive & Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, California
| | - Enihomo Obadan-Udoh
- Department of Preventive & Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, California
| | - Casey Easterday
- Survey Research Center, Bloomington, Minnesota
- HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - Chris Enstad
- HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - Sheryl Kane
- HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - William Rush
- HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - Elsbeth Kalenderian
- Department of Preventive & Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, California
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13
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Evaluation of the legal measures taken by dentists in the endodontic treatments in Turkey; A questionnaire survey. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.942061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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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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15
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Ensaldo-Carrasco E, Suarez-Ortegon MF, Carson-Stevens A, Cresswell K, Bedi R, Sheikh A. Patient Safety Incidents and Adverse Events in Ambulatory Dental Care: A Systematic Scoping Review. J Patient Saf 2021; 17:381-391. [PMID: 27611771 DOI: 10.1097/pts.0000000000000316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND There have been efforts to understand the epidemiology of iatrogenic harm in hospitals and primary care and to improve the safety of care provision. There has in contrast been very limited progress in relation to the safety of ambulatory dental care. OBJECTIVES To provide a comprehensive overview of the range and frequencies of existing evidence on patient safety incidents and adverse events in ambulatory dentistry. METHODS We searched MEDLINE and EMBASE for articles reporting events that could have or did result in unnecessary harm in ambulatory dental care. We extracted and synthesized data on the types and frequencies of patient safety incidents and adverse events. RESULTS Forty articles were included. We found that the frequencies varied very widely between studies; this reflected differences in definitions, populations studied, and sampling strategies. The main 5 PSIs we identified were errors in diagnosis and examination, treatment planning, communication, procedural errors, and the accidental ingestion or inhalation of foreign objects. However, little attention was paid to wider organizational issues. CONCLUSIONS Patient safety research in dentistry is immature because current evidence cannot provide reliable estimates on the frequency of patient safety incidents in ambulatory dental care or the associated disease burden. Well-designed epidemiological investigations are needed that also investigate contributory factors.
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Affiliation(s)
| | - Milton Fabian Suarez-Ortegon
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK
| | - Andrew Carson-Stevens
- Patient Safety Research Lead, Primary and Emergency Care Research (PRIME) Centre, Cardiff University, Wales; and Visiting Professor of Healthcare Improvement, Department of Family Practice, University of British Columbia
| | | | - Raman Bedi
- Professor and Head Centre for International Child Oral Health. King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, King's College London, UK
| | - Aziz Sheikh
- Professor of Primary Care Research & Development and Co-Director, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland
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Miao C, Yang X, Wong MC, Zou J, Zhou X, Li C, Wang Y. Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev 2021; 5:CD009858. [PMID: 33998662 PMCID: PMC8127531 DOI: 10.1002/14651858.cd009858.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in dental restorative treatments. The effects of rubber dam usage on the longevity and quality of dental restorations still require evidence-based discussion. This review compares the effects of rubber dam with other isolation methods in dental restorative treatments. This is an update of the Cochrane Review first published in 2016. OBJECTIVES To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. SEARCH METHODS Cochrane Oral Health's Information specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 13 January 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 12) in the Cochrane Library (searched 13 January 2021), MEDLINE Ovid (1946 to 13 January 2021), Embase Ovid (1980 to 13 January 2021), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 13 January 2021), and SciELO BIREME Virtual Health Library (1998 to 13 January 2021). We also searched Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 13 January 2021), VIP database (in Chinese) (1989 to 13 January 2021), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 13 January 2021). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey, and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (including split-mouth trials) over one month in length assessing the effects of rubber dam compared with alternative isolation methods for dental restorative treatments. DATA COLLECTION AND ANALYSIS Two review authors independently screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. We strictly followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included six studies conducted worldwide between 2010 and 2015 involving a total of 1342 participants (of which 233 participants were lost to follow-up). All the included studies were at high risk of bias. Five studies compared rubber dam with traditional cotton rolls isolation. One study was excluded from the analysis due to inconsistencies in the presented data. Of the four remaining trials, three reported survival rates of the restorations with a minimum follow-up of six months. Pooled results from two studies involving 192 participants indicated that the use of rubber dam isolation may increase the survival rates of direct composite restorations of non-carious cervical lesions (NCCLs) at six months (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.05 to 4.99; low-certainty evidence). However, the use of rubber dam in NCCLs composite restorations may have little to no effect on the survival rates of the restorations compared to cotton rolls at 12 months (OR 1.38, 95% CI 0.45 to 4.28; 1 study, 30 participants; very low-certainty evidence) and at 18 months (OR 1.00, 95% CI 0.45 to 2.25; 1 study, 30 participants; very low-certainty evidence) but the evidence is very uncertain. At 24 months, the use of rubber dam may decrease the risk of failure of the restorations in children undergoing proximal atraumatic restorative treatment in primary molars but the evidence is very uncertain (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97; 1 study, 559 participants; very low-certainty evidence). None of the included studies mentioned adverse effects or reported the direct cost of the treatment. AUTHORS' CONCLUSIONS This review found some low-certainty evidence that the use of rubber dam in dental direct restorative treatments may lead to a lower failure rate of the restorations compared with cotton roll usage after six months. At other time points, the evidence is very uncertain. Further high-quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
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Affiliation(s)
- Cheng Miao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyu Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - May Cm Wong
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Jing Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Abstract
The clinical dentistry and endodontic procedures involve very technique-sensitive procedures, therefore exposing the operator to risks of causes not only damage to patients but also leads to malpractice. Among various disciplines of dentistry, endodontics-related cases witness the most frequently filed malpractice claims. This is due to the fact that the endodontic treatment procedures involve operative and surgical procedures, using a variety of medicaments and techniques. The endodontic procedural errors can be preoperative errors (such as incorrect diagnosis and misinterpretation), intraoperative errors including root canal and pulp chamber perforations, ledge formation leading to apical transportation or zipping, hypochlorite accidents, and fracture of instruments. More critically, failure to use rubber dam may result in inhalation or ingestion of endodontic instruments. Under such circumstances, the endodontist may have to face legal consequences. Due to the increased healthcare load and patients’ awareness, it is important to know the legal ramifications of adverse effects, failed restorations, or other complications, to avoid any legal ramifications of endodontic procedures and associated techniques. Therefore, precautions must be taken to prevent any postsurgical complications, patient complaints, and/or failures. For this purpose, the operator must consider ethical principles and adhere strictly to the standards of healthcare while performing the diagnosis and treatment. A referral toward a specialist or consultant endodontist is always an appreciable option and should be considered in the best interest of the patient. The aim of the article is to highlight various aspects of malpractice in clinical endodontics, and associated materials and challenges. In addition, commonly occurring operating errors during endodontic treatment, possible consequences, precautions, and management have been discussed.
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Affiliation(s)
- Mothanna Alrahabi
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Munnawara, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Munnawara, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Necdet Adanir
- Department of Restorative Dentistry, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
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Prakash R, Prakash K. Fabricating a low-cost autoclavable throat screen from a steamer mat. J Prosthet Dent 2019; 121:544-545. [DOI: 10.1016/j.prosdent.2018.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 11/26/2022]
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Maroulakos G, Voulgarelis S. Impending total airway collapse involving a maxillary removable partial denture: A clinical report. J Prosthet Dent 2018; 120:642-644. [DOI: 10.1016/j.prosdent.2018.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/18/2018] [Accepted: 01/18/2018] [Indexed: 10/16/2022]
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Dental-Dam for Infection Control and Patient Safety during Clinical Endodontic Treatment: Preferences of Dental Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092012. [PMID: 30223521 PMCID: PMC6165332 DOI: 10.3390/ijerph15092012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/11/2018] [Accepted: 09/13/2018] [Indexed: 11/25/2022]
Abstract
Background: A number of factors (first experience, treating clinician and time to place dental-dam) may influence patients’ preferences regarding dental-dams. In general, patients accept placing it and that it must be used for teeth isolation during endodontic procures for the sake of patient safety and infection control. Objectives: The aim of this study is to investigate preferences and experiences of patients using dental-dam (DD) isolation during root canal treatment (RCT) and to explore influencing factors among the residents of Madinah Munnawara, Saudi Arabia. Methods: Following an ethical approval and a pilot study, a self-administrated questionnaire was distributed to 305 patients attending endodontic clinics at the Taibah University College of Dentistry (TUCOD) over six months. Patients voluntarily participated in the study after understanding the methodologies and signing a consent form. They were asked to fill out a questionnaire on their experiences and preferences in placing the DD during RCT. Data were analyzed using the Chi-square test at p = 0.05. Results: The response rate was 91%. There was no significant correlation between patients’ preferences and their race, age and gender (p > 0.05). The majority of participants (74.3%) would prefer to use a DD in their next session (p < 0.001). This preference negatively correlated with the time required to place a DD and the duration of the current visit (p < 0.001). While most of those who would prefer to use a DD in their next visit were pleased with how it was placed in the current session (76.6%), most of those who would not do so (66.7%) were uncomfortable. Overall, the highest proportion of participants (40.2%) reported that prevention of instrument swallowing was the most important advantage of DD isolation (p < 0.001). Conclusions: Overall, DD isolation for RCT is generally well accepted by patients regardless of their country of origin, gender, education and awareness of its advantages. Patients’ safety was the most attractive advantage for patients to the application of the DD. The time required to place the dental dam and first visit experience in placing the DD affect patients’ future preference.
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21
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Wang Y, Li C, Yuan H, Wong MCM, Zou J, Shi Z, Zhou X. Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev 2016; 9:CD009858. [PMID: 27648846 PMCID: PMC6457832 DOI: 10.1002/14651858.cd009858.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method. OBJECTIVES To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 17 August 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library (searched 17 August 2016), MEDLINE Ovid (1946 to 17 August 2016), Embase Ovid (1980 to 17 August 2016), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 17 August 2016), SciELO BIREME Virtual Health Library (1998 to 17 August 2016), Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 30 August 2016), VIP (in Chinese) (1989 to 30 August 2016), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 30 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (including split-mouth trials) assessing the effects of rubber dam isolation for restorative treatments in dental patients. DATA COLLECTION AND ANALYSIS Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion. MAIN RESULTS We included four studies that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations. AUTHORS' CONCLUSIONS We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
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Affiliation(s)
- Yan Wang
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Pediatric DentistryNo. 14, 3rd Section, Renmin South RoadChengduSichuanChina610041
| | - Chunjie Li
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Head and Neck OncologyNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
| | - He Yuan
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Operative Dentistry and EndodonticsNo. 14, 3rd Section, Ren Min South RoadChengduSichuanChina610041
| | - May CM Wong
- The University of Hong KongDental Public Health, Faculty of Dentistry3B20, 3/F, Prince Philip Dental Hospital34 Hospital RoadHong KongChina
| | - Jing Zou
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Pediatric DentistryNo. 14, 3rd Section, Renmin South RoadChengduSichuanChina610041
| | - Zongdao Shi
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Oral and Maxillofacial SurgeryNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
| | - Xuedong Zhou
- West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral DiseasesDepartment of Operative Dentistry and EndodonticsNo. 14, 3rd Section, Ren Min South RoadChengduSichuanChina610041
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22
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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: 24] [Impact Index Per Article: 3.0] [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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23
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Yadav RK, Yadav HK, Chandra A, Yadav S, Verma P, Shakya VK. Accidental aspiration/ingestion of foreign bodies in dentistry: A clinical and legal perspective. Natl J Maxillofac Surg 2016; 6:144-51. [PMID: 27390487 PMCID: PMC4922223 DOI: 10.4103/0975-5950.183855] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The potential of foreign body aspiration or ingestion is a worldwide health problem in dentistry. The general dental practitioners should be extremely attentive in handling of minor instruments during any intervention related to the oral cavity, especially in the supine or semi-recumbent position of the patient. Aspiration cases are usually more critical and less common than ingestion. We report a case of iatrogenic aspiration of an endodontic broach, which gets disclosed during the recording of past dental history of the patient. The patient was asymptomatic during that time. A quick posterior-anterior chest radiograph was taken which revealed the presence of broach in the lower lobe of the left lung. The patient was immediately referred to the pulmonary medicine department where the fiberoptic bronchoscope retrieval was planned, and the same was carried out successfully under local anesthesia. Although such accidents have rare occurrence, the associated risks and morbidity are too high to be overlooked, especially from the viewpoint of special care, resources, and the associated financial cost required for their management. Moreover, practitioners are also liable for malpractice litigation given the fact that such cases are avoidable. This article also discusses relevant review literature, risk factors, symptoms, and management of such iatrogenic accidents along with drawing attention to the significance of preventive measures and their role in avoiding meritorious legal and ethical issues.
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Affiliation(s)
- Rakesh Kumar Yadav
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Hemant Kumar Yadav
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, AII India Institute of Medical Sciences, New Delhi, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Simith Yadav
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Promila Verma
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar Shakya
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Aktas B, Basyigit S, Asilturk Z, Nazligul Y. Sometimes digestion has to start in the stomach in elderly patients. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Madarati AA, Bani Younes HA. Survey on the modalities of rubber dam usage for root canal treatment. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Thakral A, Sen S, Singh VP, Ramakrishna N, Mandlik VB. Aspiration of an endodontic file. Med J Armed Forces India 2016; 71:S509-11. [PMID: 26843771 DOI: 10.1016/j.mjafi.2013.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 09/24/2013] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ankur Thakral
- Dental Officer (Oral & Maxillofacial Surgery), 15 Corps Dental Unit, C/o 56 APO, India
| | - Subrato Sen
- Senior Adviser (Anaesthesia), 92 Base Hospital, C/o 56 APO, India
| | - V P Singh
- Classified Specialist (General Surgery), 92 Base Hospital, C/o 56 APO, India
| | - N Ramakrishna
- Graded Specialist (Oral & Maxillofacial Surgery), 15 Corps Dental Unit, C/o 56 APO, India
| | - V B Mandlik
- Commanding Officer, Military Dental Center, Secunderabad, C/o 56 APO, India
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27
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Mark NM, Lessing JN, Çoruh B. Crowning achievement: a case of dental aspiration. Radiol Case Rep 2015; 10:36-8. [PMID: 26649115 PMCID: PMC4661492 DOI: 10.1016/j.radcr.2015.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022] Open
Abstract
Aspiration of foreign bodies during dental procedures is a rare but potentially serious complication. We present a case of a 75-year-old man who aspirated a dental crown requiring flexible bronchoscopic retrieval. We discuss the risk factors for aspiration, the radiographic features of diagnosis, and the techniques for management and retrieval.
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Affiliation(s)
- Nicholas M Mark
- Division of Pulmonary and Critical Care, University of Washington, Box 356522, Seattle, WA 98195, USA
| | - Juan N Lessing
- Hospital Medicine Section, Department of Medicine, University of Colorado, Mail Stop F782, 12401 E. 17th Avenue, Aurora, CO 80045, USA
| | - Başak Çoruh
- Division of Pulmonary and Critical Care, University of Washington, Box 356522, Seattle, WA 98195, USA
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R M, Prasad V, Menon PA. A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation. Eur J Dent 2014; 7:225-228. [PMID: 24883031 PMCID: PMC4023191 DOI: 10.4103/1305-7456.110191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications.
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Affiliation(s)
- Mahesh R
- Department of Pedodontics and Preventive Dentistry, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Vishnu Prasad
- Department of Community Dentistry, Karpaga Vinayaka Dental College, Chennai, Tamil Nadu, India
| | - Padma A Menon
- Department of Pedodontics and Preventive Dentistry, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
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Endoscopic removal of an aspirated healing abutment and screwdriver under conscious sedation. IMPLANT DENT 2014; 23:250-2. [PMID: 24819812 DOI: 10.1097/id.0000000000000100] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Aspiration of foreign bodies during dental treatment is a medical emergency that requires prompt removal. In this study, aspiration of screwdriver and healing abutment is reported with literature review. MATERIALS AND METHODS A 26-year-old male patient was referred from a local dental clinic with the suspicion of ingestion of a screwdriver and healing abutment during the second-stage surgery. The patient reported symptoms including dyspnea, cough, and foreign body sensation. On the chest radiograph, a radiopaque foreign body resembling the screwdriver and healing abutment was observed at the right mid lung. RESULTS Bronchoscopic examination using flexible cable was performed under conscious sedation, and microforceps were used to remove the instruments. Aspirated screwdriver and healing abutment were removed safely under intravenous sedation. The patient did not have any symptoms associated with lung aspiration after removal of the foreign body during follow-up periods. CONCLUSION Bronchoscopic removal is the most recommended procedure for removal of the aspirated foreign body. This can be performed under conscious sedation. Precautions, such as tethering the screwdriver, are recommended during implant procedures.
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Cossellu G, Farronato G, Carrassi A, Angiero F. Accidental aspiration of foreign bodies in dental practice: clinical management and prevention. Gerodontology 2013; 32:229-33. [PMID: 24102914 DOI: 10.1111/ger.12068] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Foreign body aspiration is a possible complication of dental treatment that may result in a life-threatening situation. The foreign body is often spontaneously ejected from the airway, but in other cases, surgical intervention is needed. Prevention, diagnostic procedures, treatment and complications are discussed. MATERIALS AND METHODS Three cases of aspiration of dental instruments are described: the piece was localised in the right main bronchus in two cases and in the left main bronchus in one case. RESULTS All three cases underwent surgery (resection and bronchoscopy); in one case, the surgical attempt failed, and the foreign body was not located by radiography; it was assumed to have been expelled spontaneously. CONCLUSION The management of dental materials and instruments requires particular care, especially if the patient is supine or semi-recumbent. The dentist must be able to manage emergency situations in which patients accidentally inspire or swallow dental instruments or materials during treatment. Preventive techniques must be put in place because these incidents are preventable if the correct precautions are taken.
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Affiliation(s)
- Gianguido Cossellu
- Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - Giampietro Farronato
- Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - Antonio Carrassi
- Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - Francesca Angiero
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genoa, Italy
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Ashkenazi M, Bijaoui E, Blumer S, Gordon M. Common mistakes, negligence and legal offences in paediatric dentistry: a self-report. Eur Arch Paediatr Dent 2012; 12:188-94. [DOI: 10.1007/bf03262805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Singh G, Gambhir RS, Singh S, Kaur H. Accidental aspiration of dental crowns and retrieval. J Contemp Dent Pract 2012; 13:716-8. [PMID: 23250181 DOI: 10.5005/jp-journals-10024-1215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this article is to create awareness among the dental practitioners regarding the various accidents which can happen during a dental procedure and stress upon the preventive measures that can be taken to reduce the same. BACKGROUND This article presents a case of aspiration of dental crowns by the patient and its retrieval by coughing and preventive measures which can be taken to avoid such circumstances. CASE DESCRIPTION A patient reporting to private dental practice accidentally aspirated the two-unit prosthesis (crowns) in the right lung during cementation. He was immediately taken to the hospital, where chest radiographs and computed tomographic (CT) scan were done in order to locate the actual position of the prosthesis. Bronchoscopy was planned to retrieve the crowns but the patient had a bout of cough and the crowns came out. A chest radiograph was taken to confirm the absence of crowns. CLINICAL SIGNIFICANCE Taking adequate precautions while performing any dental procedure in supine position can decrease the occurrence of such incidents. Rigid bronchoscopy is the advised method of retrieval in case the crowns are not coughed out.
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Affiliation(s)
- Gurminder Singh
- Department of Prosthodontics, Gian Sagar Dental College & Hospital, Rajpura-140601, Punjab, India.
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Obinata K, Satoh T, Towfik AM, Nakamura M. An investigation of accidental ingestion during dental procedures. J Oral Sci 2012; 53:495-500. [PMID: 22167036 DOI: 10.2334/josnusd.53.495] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Twenty-three cases of accidental ingestion during dental procedures, which occurred at the Center for Dental Clinics of Hokkaido University Hospital between 2006 and 2010, were analyzed retrospectively. We examined not only the objects ingested, but also details of the circumstances (treated teeth, types of treatment, professional experience of the practitioners). Except for two cases (an unidentified endodontic file and the tip of an ultrasonic scaler, which were recovered by vacuuming), the other 21 accidentally ingested objects were all found in the digestive tract, and none in the respiratory tract, by radiographic examination of the chest and abdomen. The ingested objects were mostly metal restorations (inlays or onlays) or prostheses (crowns or cores). Ingestion occurred more frequently during treatment of lower molars, and when procedures were being conducted by practitioners with less than 5 years of experience. No adverse events related to ingestion were reported. The present study found no cases of aspiration or complications related to the ingested objects. However, considering the risk of life-threatening emergencies related to accidental aspiration and ingestion, dentists must take meticulous precautions and be ready to deal with this kind of emergency during dental procedures.
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Affiliation(s)
- Kenichi Obinata
- Department of Dental Radiology, Hokkaido University Hospital, Sapporo, Japan.
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Brunton PA, Burke FJT, Sharif MO, Creanor S, Hosey MT, Mannocci F, Wilson NHF. Contemporary dental practice in the UK in 2008: aspects of direct restorations, endodontics and bleaching. Br Dent J 2012; 212:63-7. [PMID: 22281627 DOI: 10.1038/sj.bdj.2012.46] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate, by postal questionnaire, aspects of the selection and use of direct restorative materials, endodontic techniques and approaches to bleaching by general dental practitioners in the UK, and to compare and contrast the findings with those of a related study reported in 2004. METHODS A questionnaire comprising 18 questions, each of a number of elements, was sent to 1,000 general dental practitioners in the UK, selected at random from the Dentists Register. Non-responders were sent a second copy of the questionnaire after a period of four weeks had elapsed. RESULTS A total of 662 useable responses were returned, giving a response rate of 66%. Key findings included: dental amalgam was found to be the most commonly used material in the restoration of occlusoproximal cavities in premolar (59% of respondents) and molar teeth (75% of respondents); glass-ionomer cements and related materials were applied extensively in the restoration of deciduous molars (81% of respondents) and for the luting of indirect restorations (67% of respondents); the use of rubber dam was limited, in particular as an adjunct to procedures in operative dentistry (18% of respondents); relatively few respondents used preformed stainless steel crowns, and among the users only occasionally in the restoration of deciduous molars (23%); and bleaching, predominantly home-based (nightguard) vital bleaching (81% of respondents) was widely practised. CONCLUSION It is concluded that, for the practitioners surveyed, factors other than best available evidence influenced various aspects of the use of direct restorative materials and the clinical practice of endodontics. As a consequence, many of the features of general dental practice revealed in the process of the investigation were at variance with teaching in dental schools. Bleaching, in particular home-based (nightguard), vital bleaching, was provided by >80% of respondents, indicating widespread interest among patients in enhanced dental attractiveness.
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Affiliation(s)
- P A Brunton
- Restorative Dentistry, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU.
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Venkataraghavan K, Anantharaj A, Praveen P, Rani SP, Krishnan BM. Accidental ingestion of foreign object: Systematic review, recommendations and report of a case. Saudi Dent J 2011; 23:177-81. [PMID: 23960513 PMCID: PMC3723260 DOI: 10.1016/j.sdentj.2010.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 10/12/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022] Open
Abstract
One of the serious complications during a routine endodontic procedure is accidental ingestion/aspiration of the endodontic instruments, which can happen when proper isolation is not done. There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. A 5 year old boy reported to the Department of Pediatric and Preventive Dentistry, D.A. Pandu Memorial R.V. Dental College, Bangalore, India, with a complaint of pain and swelling in the lower right back teeth region. Endodontic therapy was planned for the affected tooth. During the course of treatment the child accidentally swallowed a 21 mm 15 size K file. Endoscopy was performed immediately but the instrument could not be retrieved. The instrument passed out uneventfully along with the stools 48 h after ingestion. Careful evaluation of the patient immediately after the accident helps in managing the patient effectively along with following the recommended guidelines.
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Affiliation(s)
- Karthik Venkataraghavan
- Department of Pediatric and Preventive Dentistry, D.A. Pandu Memorial R.V. Dental College, Bangalore, India
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Deliberador TM, Marengo G, Scaratti R, Giovanini AF, Zielak JC, Filho FB. Accidental aspiration in a patient with Parkinson's disease during implant-supported prosthesis construction: A case report. SPECIAL CARE IN DENTISTRY 2011; 31:156-61. [DOI: 10.1111/j.1754-4505.2011.00202.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Baghele ON, Baghele MO. Accidental ingestion of BiTine ring and a note on inefficient ring separation forceps. Ther Clin Risk Manag 2011; 7:173-9. [PMID: 21691588 PMCID: PMC3116805 DOI: 10.2147/tcrm.s19725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Indexed: 11/23/2022] Open
Abstract
Background: Accidental ingestion of medium-to-large instruments is relatively uncommon during dental treatment but can be potentially dangerous. A case of BiTine ring ingestion is presented with a note on inefficient ring separation forceps. Case description: A 28-year-old male patient accidentally ingested the BiTine ring (2 cm diameter, 0.5 cm outward projections) while it was being applied to a distoproximal cavity in tooth # 19. The ring placement forceps were excessively flexible; bending of the beaks towards the ring combined with a poor no-slippage mechanism led to sudden disengagement of the ring and accelerated movement towards the pharynx. We followed the patient with bulk forming agents and radiographs. Fortunately the ring passed out without any complications. Clinical implications: Checking equipment and methods is as important as taking precautions against any preventable medical emergency. It is the responsibility of the clinician to check, verify and then use any instrument/equipment.
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Affiliation(s)
- Om Nemichand Baghele
- Department of Periodontology, SMBT Dental College and Hospital, Sangamner, Ahmednagar, Maharashtra, India
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Gilbert GH, Litaker MS, Pihlstrom DJ, Amundson CW, Gordan VV. Rubber dam use during routine operative dentistry procedures: findings from the Dental PBRN. Oper Dent 2010; 35:491-9. [PMID: 20945739 DOI: 10.2341/09-287c] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Rubber dam use during operative dentistry procedures has been quantified based on questionnaires completed by dentists. However, based on the knowledge of the authors of the current study, there are no reports based on use during actual clinical procedures other than in dental materials studies and none based on routine care. The objectives of the current study were to: 1) quantify how commonly the rubber dam is used during operative dentistry procedures; 2) test the hypothesis that certain dentist, restoration and patient-level factors are associated with its use. A total of 229 dentist practitioner-investigators in The Dental Practice-Based Research Network (DPBRN) participated. DPBRN comprises five regions of the USA: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates and Scandinavia. Practitioner-investigators collected data on 9,890 consecutive restorations done in previously unrestored tooth surfaces from 5,810 patients. Most dentists (63%) did not use a rubber dam for any restoration in this study. A rubber dam was used for only 12% of restorations, 83% of which were used in one DPBRN region. With regions accounted for, no other dentist characteristics were significant. A multi-level multiple logistic regression of rubber dam use was done with restoration and patient-level variables modeled simultaneously. In this multi-variable context, these restoration-level characteristics were statistically significant: tooth-arch type, restoration classification and reason for placing the restoration. These patient-level characteristics were statistically significant: ethnicity, dental insurance and age. These results, obtained from actual clinical procedures rather than questionnaires, document a low prevalence of usage of the rubber dam during operative dentistry procedures. Usage varied with certain dentist, restoration and patient-level characteristics.
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Affiliation(s)
- Gregg H Gilbert
- Department of General Dental Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA.
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Webber J. Risk management in clinical practice. Part 4. Endodontics. Br Dent J 2010; 209:161-70. [DOI: 10.1038/sj.bdj.2010.721] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2009] [Indexed: 11/09/2022]
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Abstract
Rubber dam has been available to the dental profession for over 140 years. During this time, the use of rubber dam has been perfected, universally taught and recommended by professional organizations. Unfortunately, its consistent use has been rejected by many in the profession. The literature suggests that rubber dam is not used routinely by dental practitioners for root canal treatment. Many unfounded reasons have been cited for its lack of use, including concerns over patient acceptance, time required for application, cost of equipment and materials, insufficient training, difficulty in use and low treatment fees. Failure to use rubber dam has been shown to influence the choice of root canal irrigant, has a negative impact on treatment outcome and places the patient at risk of swallowing or aspirating materials and instruments. Methods to popularize rubber dam amongst general practitioners are discussed.
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Affiliation(s)
- I A Ahmad
- Private Dental Practice, Amman, Jordan.
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Silva RF, Martins EC, Prado FB, Júnior JRC, Júnior ED. Endoscopic removal of an endodontic file accidentally swallowed: clinical and legal approaches. AUST ENDOD J 2009; 37:76-8. [PMID: 21771188 DOI: 10.1111/j.1747-4477.2009.00220.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of a rubber dam is an essential procedure when treating root canals, and not using it may compromise the success of the treatment, as well as the patient's health. This report presents a case in which a K-file was accidentally swallowed during an endodontic procedure, performed without the use of a rubber dam. Given the absence of immediate clinical complications, the subject underwent a chest radiograph. The file was located at the oesophagogastric junction and was later removed by endoscopy. In addition to the clinical repercussions, this example also illustrates the ethical-legal aspects of this type of accident.
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Affiliation(s)
- Rhonan F Silva
- Department of Legal Dentistry/Morphology, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil.
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Affiliation(s)
- Edward E. Hill
- Department of Care Planning and Restorative Sciences; University of Mississippi School of Dentistry
| | - Barry S. Rubel
- Department of Care Planning and Restorative Sciences; University of Mississippi School of Dentistry
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Lankisch TO, Manns MP, Wedemeyer J. Why men should not iron: unperceived swallowed dental root instrument causes seven years of abdominal pain. Clin Gastroenterol Hepatol 2008; 6:xxxii. [PMID: 18514036 DOI: 10.1016/j.cgh.2008.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 01/23/2008] [Accepted: 01/29/2008] [Indexed: 02/07/2023]
Affiliation(s)
- Tim Oliver Lankisch
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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