Removal of a foreign body (artificial tooth) from the bronchial tree: a new method

Aspiration of dental items: Case report with literature review and proposed management algorithm

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.

Aspiration of the dental crown in an elderly patient

The aspiration of objects and foreign bodies requires quick and systematic care. During emergent orotracheal intubation, accidental dental crown release can cause a threat to the patient's life. This paper aimed to report a case of foreign body (dental prosthetic crown) aspiration and its management and discuss alternative approaches. An 81-year-old male patient, who was admitted to the hospital's intensive care unit (ICU) for meningitis, presented with altered consciousness, and decreased oxygen saturation. He underwent emergent orotracheal intubation. After intubation, chest radiography was performed to check for proper orotracheal tube positioning and lung expansion. The resultant images revealed the presence of a foreign body within the right lower lobe bronchus in the shape of a dental crown. The foreign body, intubation cannula and basket clamp were successfully removed, followed by reintubation of the patient. The foreign body was a prosthetic upper premolar dental crown (24). While care should be taken to avoid complications, if a foreign body is aspirated during emergent orotracheal intubation, endoscopic removal appears safe and effective. Careful creation, placement, maintenance, and preservation of prosthetic crowns are critically important in elderly patients.

Swallowed and aspirated dental prostheses and instruments in clinical dental practice: a report of five cases and a proposed management algorithm

BACKGROUND

Accidental swallowing or aspiration of dental instruments and prostheses is a complication of dental procedures. Failure to manage these complications appropriately can lead to significant morbidity and possibly death.

CASE DESCRIPTION

The authors present three cases of accidental swallowing of dental instruments during procedures and two cases of aspiration, one during a procedure and one long after the procedure. Although three of these five cases of foreign-body aspiration or ingestion were caught early and the patients were referred for endoscopic retrieval, two patients experienced prolonged symptoms that affected their quality of life before intervention occurred. Practical Implications The authors reviewed the literature and propose an evidence-based algorithm for management of such complications. Adherence to the proposed algorithm may decrease morbidity and mortality and improve patient outcomes.

An unusual foreign body in the foot: traumatic implantation of a human tooth

We report the case of a 29-year-old man who presented to the emergency department with persistent swelling and pain in his right foot, initially reported to be related to stepping on something while walking on the beach. When radiographs showed what appeared to be a human tooth embedded in the foot, the patient admitted to having been in a fight, during which he kicked his opponent in the jaw with his foot. The tooth was surgically removed and oral antibiotic therapy was administered for 1 week. The wound eventually healed by secondary intention without complications, and the patient returned to his regular activities 15 days after the operation.

Tooth aspiration: its relevance in medicolegal autopsies

Tooth aspiration in adulthood is an uncommon autopsy finding. The paper presents two cases in which maxillary incisors had been avulsed and inhaled during hospital treatment and in the course of maxillofacial trauma, respectively. In the first case, repeated attempts to remove the aspirated tooth by means of flexible bronchoscopy led to perforation of the bronchial wall with consecutive bleeding into the deep airways and fatal asphyxia. In the second case, the fact of tooth aspiration remained undetected throughout the 3-day survival time until death from craniocerebral trauma. The paper points out the forensic aspects of tooth aspiration against the background of the relevant clinical literature.

Use of an image intensifier to remove a challenging foreign body in a segmental bronchiole

Aspiration of foreign bodies into the tracheobronchial tree is a common presentation in children, but less so in adults. Successful extraction depends on the type of foreign body aspirated, location of the foreign body in the tracheobronchial tree, the experience of the operator and the instrumentation available. We report on our management of a patient who presented with an aspirated foreign body.