Displacement of tooth fragments to the lower lip: a report of a case presenting an immediate diagnostic approach

Be Qui Vive: Unravel the Mystery of Undiagnosed for Better Prognosis

Foreign bodies may access the oral cavity by trauma or iatrogenically. Iatrogenic foreign bodies that are frequently encountered include amalgam, obturation materials, shattered equipment, needles, broken teeth, and so on. Impaction of a tooth or bone fragment in the soft tissues is one type of dental trauma. When foreign bodies are found in the teeth, it's a highly grave scenario that requires prompt diagnosis. Thorough case histories, clinical assessments, and radiographic analyses are required to draw conclusions regarding the type, dimensions, location, and challenge of the foreign body retrieval. Due to the well-known tendency of children to put foreign objects in their mouths, it is more frequently observed in them. From time to time, children get strange items lodged in their teeth, which they are afraid to tell their parents about. These foreign objects might store possible infections, which could eventually result in a painful condition. This paper discusses the presence of unusual foreign bodies-a broken pencil and tooth fragment-and their management.

How to cite this article

Kaul B, Gulbar S, Gupta A, et al. Be Qui Vive: Unravel the Mystery of Undiagnosed for Better Prognosis. Int J Clin Pediatr Dent 2024;17(4):501-509.

Complications Arising from Dental Trauma Incurred from Falls Involving Geriatric Patients: A Case Report

Elderly patients have a high incidence of falls that result in facial injuries. Many cases present with dental crown fractures and soft-tissue lacerations. The initial diagnosis is especially important in this type of dental trauma, since an initial error can result in the failure to establish the correct treatment from the very beginning, worsening the prognosis, which, in the worst case, can compromise the teeth affected by the trauma. Case report: We present the case of a patient, a 79-year-old woman, who suffered an accidental fall. The patient was examined by a dentist in the emergency room. She was diagnosed with a simple crown fracture of the right upper central incisor and right upper lateral incisor without any pulpal involvement and with laceration of the lower lip. Months later, she had an episode of inflammation in the lower lip, and she developed edema and pain. An X-ray of the lower lip revealed a radiopaque mass compatible with a fragment of dental tissue due to the inclusion of remnants of the dental tissue resulting from the previous accident fall. Conclusions: The population of geriatric patients is steadily increasing in our society, and a higher frequency of falls has been observed in this age group, affecting the maxillofacial region, with consequent dental trauma on many occasions. Therefore, as professionals, we must pay special attention to the prevention and treatment of this problem, insisting on the importance of routine investigation in the emergency visit for dental trauma, which includes a meticulous examination of the soft tissues accompanied by a radiographic examination, when the inclusion of foreign bodies is suspected.

Imaging Utilization Patterns and Injury Characteristics Associated with Electric Standing Scooters in a Major Urban Area

BACKGROUND

The recent proliferation of electric standing scooters in major urban areas of the United States has been accompanied by injuries of varying severity and nature, representing a growing public health concern.

OBJECTIVE

Our aim was to characterize imaging utilization patterns for injuries associated with electric scooter (e-scooter) use, including their initial emergency department (ED) management.

METHODS

We conducted a retrospective review of the electronic medical record for all patients presenting to affiliated EDs for e-scooter-related injuries between July 2018 and April 2020. Demographics, date and time of presentation, imaging study type, resultant injury, and procedural details were recorded.

RESULTS

Ninety-seven patients were included; mean age was 27.6 years. Of these, 55 patients (57%) had injuries identified on imaging and 40% of all imaging studies were positive. Most identified injuries (61%) were musculoskeletal, with a small number of neurological (2%) and genitourinary (1%) injuries. The highest prevalence of presentations occurred in August; most patients (72%) presented between 3 pm and 1 am and granular peaks were between 12 am and 1 am and 5 pm and 6 pm.

CONCLUSIONS

Patients presenting with e-scooter injuries have a high likelihood of injury to the radial head, nasal bone, and malleoli. Emergency physicians should be especially vigilant for injuries in these areas at presentation. Visceral injuries are uncommon but may be severe enough to warrant surgery.

Hair tourniquet of the circumvallate papillae: a potentially "hairy" situation

Oral foreign bodies and hair-thread tourniquets are fairly common findings. The combination of the two, however, is rarer. In this article, we present a case involving a hair-thread tourniquet of a circumvallate papillae (more commonly known as a "taste bud"). We discuss methods for removal of hair-thread tourniquets as well as techniques for examining children for oral foreign bodies.

Treatment imprudence leading to missed tooth fragment

Traumatic dental injuries (TDI) represent one of the most common oral health problems in children and adolescents. Dental trauma requires a special consideration when it accompanies soft tissue lacerations. Tooth fragments occasionally penetrate into soft tissues and may cause severe complications. This article describes the case of a 12-year-old girl with a fractured tooth fragment embedded in the lower lip for 4 months, which went unnoticed at her primary health centre. This report highlights the importance of proper radiographic diagnosis along with clinical examination after trauma in order to prevent any future complications.

Tooth embedded in tongue following firearm trauma: report of two cases

Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.

Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination

This article describes a child patient who initially had inadequate treatment and suffered concomitant soft tissue trauma involving complete displacement of a primary central incisor into the lip tissue. The primary tooth was subsequently removed by surgery under general anesthesia. Despite the delay in diagnosis, there was an excellent outcome following removal of the embedded tooth. This paper again emphasizes the importance of an accurate history, physical, and radiographic evaluation of these patients in the acute phase. The importance of soft tissue inspection even in cases that are presented late for dental trauma management is also highlighted. This case shows that educated emergency room staff preferably including an oral and maxillofacial surgeon is required for a proper emergency management in orofacial traumas.

The importance of soft tissue examination in traumatic dental injuries: a case report

Traumatic dental injuries (TDIs) represent one of the main oral health problems in children, with variable prevalence rates. The issue of unmet treatment needs and inadequate emergency management of TDIs have surfaced up lately in dental literature, indicating that some TDIs present late for treatment, which may complicate management of these injuries. Soft tissue injuries usually accompany other dental injuries therefore thorough clinical and radiographic inspection of soft tissue wounds can not be over emphasized, even in late presentation cases. Tooth fragments may be embedded in soft tissues, even in late presentation cases, and may go unnoticed in the presence of urgent situations. This case report presents a child with a fractured tooth fragment embedded in the lower lip for 18 months, which went unnoticed until the child presented later for treatment of the fractured incisor, highlighting the importance of soft tissue exploration even in late presentation trauma cases.