Accidental impaction of partial dental prostheses in the upper gastrointestinal tract

Accidental ingestion or aspiration of foreign objects at Tokyo Dental College Chiba Hospital over last 4 years

The aim of this study was to investigate cases of accidental ingestion or aspiration occurring at Tokyo Dental College Chiba Hospital over the last 4 years in order to determine how the incidence of such events could be reduced. Forty cases of accidents occurring at our hospital over a 4-year period commencing in 2008 (representing 27% of the total number of accidents) included accidental ingestion in 39 patients and aspiration in one. Most of these accidents occurred during the removal or placement of restorations or prosthetics, and the ingested objects were mostly crowns and inlays. Accidental ingestion or aspiration occurred more frequently in the right molar region and when procedures were conducted by practitioners with less than 1 to 7 years of experience, and especially 1 to 3 years only. A higher rate of such accidents was observed in male patients in their 50s to 70s. The conventional safety procedures developed by the Medical Risk Management Team should be adhered to wherever possible. Furthermore, we propose the following measures based on the present results: accident prevention training for students and clinical trainees; improvement of the in-hospital manual; personal coaching for those breaching the guidelines of the safety manual; and raising awareness of the need for greater care in preventing incidents of accidental ingestion or aspiration at the Tokyo Dental College Chiba Hospital.

Iatrogenic Damage to the Periodontium Caused by Removable Prosthodontic Treatment Procedures: An Overview

As the number of aged people in the world is growing, the need to provide patients with tooth alternate through removable partial dentures is equally growing. There are adversarial effects that should be kept in mind which might disturb the remaining teeth; specially, the abutments and the supporting tissues. These effects might spread to the muscles of mastication and also to the supporting periodontal tissues. Thus, we should plan removable partial dentures (RPDs) without mutilation to the adjacent teeth or the underlying tissues.

Accidental ingestion of BiTine ring and a note on inefficient ring separation forceps

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.

Accidental swallowing of partial denture: a case report

We describe a 42-year-old age woman who accidentally swallowed her lower denture, which was composed of eleven teeth. The daily descent of the denture was followed by plain abdominal radiography and physical examination. The image was localized at the left upper quadrant on admission day, but it stopped on its way at the right lower quadrant on day two and three. Since the patient's complaints increased we planned surgical removal of the denture. In this report, we had discussed the diagnosis, follow up and treatment options of swallowed partial denture with current literature review.

Laparoscopic Removal of an Intragastric Foreign Body With Endoscopic Assistance

We report the successful laparoscopic removal of an intragastric foreign body. A 57-year-old woman who had accidentally swallowed her own partial denture was referred to our hospital for its removal. Laparoscopic removal of the foreign body was urgently performed with the assistance of oral endoscope, following an earlier failed endoscopic removal associated with subcutaneous and mediastinal emphysema. The foreign body was removed from the stomach through a gastrotomy. There were no perioperative complications. The patient was uneventfully discharged on the ninth postoperative day. Laparoscopic removal of an intragastric foreign body is a feasible and safe treatment, and can be an alternative choice following failed endoscopic removal.

Swallowed partial dentures

Swallowed or inhaled partial dentures can present a diagnostic challenge. Three new cases are described, one of them near-fatal because of vascular erosion and haemorrhage. The published work points to the importance of good design and proper maintenance. The key to early recognition is awareness of the hazard by denture-wearers, carers and clinicians.

Swallowed partial dentures

Swallowed or inhaled partial dentures can present a diagnostic challenge. Three new cases are described, one of them near-fatal because of vascular erosion and haemorrhage. The published work points to the importance of good design and proper maintenance. The key to early recognition is awareness of the hazard by denture-wearers, carers and clinicians.

The location and tracking of swallowed dental appliances: the role of radiology

Two cases of swallowing mishaps, one involving a spoon-denture and the other an orthodontic partial arch wire, are reported. The former was recovered following interventional radiology, the latter by proctoscopy. The role of radiographic investigation and possible measures to prevent such potential life-threatening emergencies are discussed.