Advertisement

Oral and Maxillofacial Surgery

, Volume 14, Issue 1, pp 43–47 | Cite as

Bronchial impaction of an implant screwdriver after accidental aspiration: report of a case and revision of the literature

  • Lorena Pingarrón Martín
  • María José Morán Soto
  • Rocío Sánchez Burgos
  • Miguel Burgueño García
Case Report

Abstract

Background

Adverse outcomes resulting from aspiration or ingestion of instruments and materials can occur in any dental procedure. Clinical manifestation depends on the location, the obstructive potential of the foreign body, and the temporal factor since the accidental incident. Accidental inhalation of dental appliances can be an even more serious event than ingestion and must always be treated as an emergency situation.

Case report

A 62-year-old woman was admitted to our hospital with the suspicion of ingestion of a screwdriver implants. In spite of the clinically asymptomatic presentation, chest radiography in posteroanterior and lateral projections showed a radiopaque dental instrument impacted on the right main inferior bronchus. Rigid bronchoscope was successful to remove the dental instrument under general anesthesia, and the patient was discharged 24 h later.

Conclusion

Aspiration and ingestion of dental foreign objects are infrequent, but they can occur at large multidisciplinary dental procedures. These episodes have the potential to result in acute medical and life-threatening emergencies since the beginning of the event or at a late stage in proceeding in the underdiagnosed patient. Prevention of such incidents is, therefore, the best approach via the mandatory use of precautions during all dental procedures, and in case of suspicion with no retrievable material, patient must always be submitted to a radiographic study.

Keywords

Implant screwdriver Aspiration Bronchoscopy Bronchial impaction 

References

  1. 1.
    Cameron SM, Whitlock WL, Tabor MS (1996) Foreign body aspiration in dentistry: a review. J Am Dent Assoc 127:1224–1229PubMedGoogle Scholar
  2. 2.
    Tiwana KK, Morton T, Tiwana PS (2004) Aspiration and ingestion in dental practice: a 10-year institutional review. J Am Dent Assoc 135:1287–1291PubMedGoogle Scholar
  3. 3.
    Bergermann M, Donald PJ, Wengen DF (1992) Screwdriver aspiration. A complication of dental implant placement. Int J Oral Maxillofac Surg 21:339–341CrossRefPubMedGoogle Scholar
  4. 4.
    Hodges ED, Durham TM, Stanley RT (1992) Management of aspiration and swallowing incidents: a review of the literature and report of case. ASDC J Dent Child 59(6):413–419PubMedGoogle Scholar
  5. 5.
    Donado JR, De Miguel E, Casado ME, Alfaro JJ (1998) Tracheobronchial foreign body extraction with fiberoptic bronchoscopy in adults. Arch Bronconeumol 34:76–81Google Scholar
  6. 6.
    Dikensoy O, Usalan C, Filiz A (2002) Foreign body aspiration: clinical utility of flexible bronchoscopy. Postgrad Med J 78:399–403CrossRefPubMedGoogle Scholar
  7. 7.
    McArthur DR, Taylor DF (1975) A determination of the minimum radiopacification necessary for radiographic detection of an aspirated or swallowed object. Oral Surg Oral Med Oral Pathol 39(2):329–338CrossRefPubMedGoogle Scholar
  8. 8.
    Fields RT, Schows SR (1998) Aspiration and ingestion of foreign bodies in oral and maxillofacial surgery; a review of the literature and report of five cases. Am J Oral Maxillofacial Surg 56:1091–1098CrossRefGoogle Scholar
  9. 9.
    Heimlich HJ (1975) A life-saving maneuver to prevent food-choking. J Am Med Assoc 234:398–401CrossRefGoogle Scholar
  10. 10.
    Heimlich HJ (1977) The Heimlich maneuver: prevention of death from choking on foreign bodies. J Occup Med 19:208–210PubMedGoogle Scholar
  11. 11.
    Dierks EJ (2008) Traqueotomy: elective and emergent. Oral Maxillofac Surg Clin North Am 20(3):513–512CrossRefPubMedGoogle Scholar
  12. 12.
    Zitzmann NU, Elsasser S, Fried R, Marinello CP (1999) Foreign body ingestion and aspiration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:657–660CrossRefPubMedGoogle Scholar
  13. 13.
    Maleki M, Evans WE (1970) Foreign-body perforation of the intestinal tract. Arch Surg 101:475–477PubMedGoogle Scholar
  14. 14.
    Martinot A, Closset M, Marquette CH et al (1997) Indications for flexible versus rigid bronchoscopy in children with suspected foreign body aspiration. Am J Respir Crit Care Med 155:1676–1679PubMedGoogle Scholar
  15. 15.
    Henderson CT, Engel J, Schlesinger P (1987) Foreign body ingestion; review and suggested guidelines for management. Endoscopy 19:68–71CrossRefPubMedGoogle Scholar
  16. 16.
    Brady PG (1995) Management of esophageal and gastric foreign bodies. Gastrointest Endosc 42:622–625CrossRefGoogle Scholar
  17. 17.
    Milton TM, Hearing SD, Ireland AJ (2001) Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident Management. Br Dent J 190:592–596CrossRefPubMedGoogle Scholar
  18. 18.
    Webb WA (1988) Management of foreign bodies of the upper gastrointestinal tract. Gastroenterol 94:204–216Google Scholar
  19. 19.
    Soergel KH, Hogan WJ (1983) Therapeutic endoscopy. Hosp Pract 18:81–92Google Scholar
  20. 20.
    D’Ovidio C, Carnevale A, Pantaleone G (2008) A case of accidental aspiration of a dental cutter into the bronchopulmonary tree:clinical implications and legal considerations. Minerva Stomatol 57(10):535–547PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Lorena Pingarrón Martín
    • 1
  • María José Morán Soto
    • 1
  • Rocío Sánchez Burgos
    • 1
  • Miguel Burgueño García
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryLa Paz University HospitalMadridSpain

Personalised recommendations