1
|
Zaidi SAA, Ilyas F, Hakeem S, Feroze A, Sarfaraz S, Ali SK. Determining the psychometric properties of a written test to assess safe dental practice. BMJ Open Qual 2024; 13:e002384. [PMID: 38719519 PMCID: PMC11086408 DOI: 10.1136/bmjoq-2023-002384] [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: 04/22/2023] [Accepted: 09/11/2023] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Safe practice in medicine and dentistry has been a global priority area in which large knowledge gaps are present.Patient safety strategies aim at preventing unintended damage to patients that can be caused by healthcare practitioners. One of the components of patient safety is safe clinical practice. Patient safety efforts will help in ensuring safe dental practice for early detection and limiting non-preventable errors.A valid and reliable instrument is required to assess the knowledge of dental students regarding patient safety. OBJECTIVE To determine the psychometric properties of a written test to assess safe dental practice in undergraduate dental students. MATERIAL AND METHODS A test comprising 42 multiple-choice questions of one-best type was administered to final year students (52) of a private dental college. Items were developed according to National Board of Medical Examiners item writing guidelines. The content of the test was determined in consultation with dental experts (either professor or associate professor). These experts had to assess each item on the test for language clarity as A: clear, B: ambiguous and relevance as 1: essential, 2: useful, not necessary, 3: not essential. Ethical approval was taken from the concerned dental college. Statistical analysis was done in SPSS V.25 in which descriptive analysis, item analysis and Cronbach's alpha were measured. RESULT The test scores had a reliability (calculated by Cronbach's alpha) of 0.722 before and 0.855 after removing 15 items. CONCLUSION A reliable and valid test was developed which will help to assess the knowledge of dental students regarding safe dental practice. This can guide medical educationist to develop or improve patient safety curriculum to ensure safe dental practice.
Collapse
Affiliation(s)
- Syed Akbar Abbas Zaidi
- Dental Education Department, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Farnaz Ilyas
- Prosthodontics, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Saman Hakeem
- Prosthodontics, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Asher Feroze
- Health Research Advisory Board, HealthRAB, Karachi, Pakistan
| | - Shaur Sarfaraz
- Medical Education, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Syeda Kausar Ali
- Institute of Medical Education, Jinnah Sindh Medical University, Karachi, Pakistan
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Yu YC, Yang CW, Chang YC. Legal risk analysis of swallowing endodontic file using American cases. J Dent Sci 2023; 18:489-490. [PMID: 36643263 PMCID: PMC9831830 DOI: 10.1016/j.jds.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/16/2022] [Indexed: 12/24/2022] Open
|
4
|
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]
|
5
|
Kunaparaju K, Shetty K, Jathanna V, Nath K, M R. Endoscopic retrieval of an accidentally ingested bur during a dental procedure: a case report. Patient Saf Surg 2021; 15:1. [PMID: 33402200 PMCID: PMC7786993 DOI: 10.1186/s13037-020-00273-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/03/2020] [Indexed: 01/08/2023] Open
Abstract
Background Accidental ingestion of a dental bur during the dental procedure is a rare, but a potentially serious complication. Early recognition and foreign body retrieval is essential to prevent adverse patient outcomes. Case presentation A 76-year old male patient, presented to the department with a chief complaint of sensitivity in his upper right back tooth due to attrition. After assessing the pulp status, root canal therapy was planned for the tooth. During the procedure, it was noticed that the dental bur slipped out of the hand piece and the patient had accidentally ingested it. The patient was conscious and had no trouble while breathing at the time of ingestion of the bur although he had mild cough which lasted for a short duration. The dental procedure was aborted immediately and the patient was taken to the hospital for emergency care. The presence and location of the dental bur was confirmed using chest and abdominal x-rays and it was subsequently retrieved by esophagogastroduodenoscopy (EGD) procedure under general anaesthesia on the same day as a part of the emergency procedure. The analysis of this case reaffirms the importance of the use of physical barriers such as rubber dams and gauze screens as precautionary measures to prevent such incidents from occurring. Conclusion Ingestion of instruments are uncertain and hazardous complications to encounter during a dental procedure. The need for physical barrier like rubber dam is mandatory for all dental procedures. However, the dentist should be well trained to handle such medical emergencies and reassure the patient by taking them into confidence. Each incident encountered should be thoroughly documented to supply adequate guidance for treatment aspects. This would fulfil the professional responsibilities of the dentist/ clinician and may help avoid possible legal and ethical issues. This case report emphasizes on the need for the usage of physical barriers during dental procedures in order to avoid medical emergencies.
Collapse
Affiliation(s)
- Keerthana Kunaparaju
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vinod Jathanna
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kartik Nath
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Melaka Manipal Medical College, Manipal, India
| | - Roma M
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.
| |
Collapse
|
6
|
P N R, C H M, Singh R, George A, G V. Missing teeth after maxillofacial trauma: a case report and management protocol. J Korean Assoc Oral Maxillofac Surg 2020; 46:422-427. [PMID: 33377468 PMCID: PMC7783178 DOI: 10.5125/jkaoms.2020.46.6.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 11/07/2022] Open
Abstract
Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.
Collapse
Affiliation(s)
- Ramaraj P N
- Department of Oral and Maxillofacial Surgery, K.V.G. Dental College and Hospital, Sullia, India
| | - Mahabaleshwara C H
- Department of Oral and Maxillofacial Surgery, K.V.G. Dental College and Hospital, Sullia, India
| | - Rohit Singh
- Department of Oral and Maxillofacial Surgery, K.V.G. Dental College and Hospital, Sullia, India
| | - Abhijith George
- Department of Oral and Maxillofacial Surgery, K.V.G. Dental College and Hospital, Sullia, India
| | - Vijayalakshmi G
- Department of Oral and Maxillofacial Surgery, K.V.G. Dental College and Hospital, Sullia, India
| |
Collapse
|
7
|
Liu Y, Lin Y, Di P. A modified implant abutment holder fabricated with fused deposition modeling to improve the transfer process for implant-supported restorations. J Prosthet Dent 2020; 125:411-414. [PMID: 32248997 DOI: 10.1016/j.prosdent.2020.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 10/24/2022]
Abstract
Ingestion or aspiration of an implant abutment can occur in patients during the process of abutment transfer for implant-supported restorations, especially in the posterior region. A technique of fabricating an abutment holder is described to prevent ingestion or aspiration by computer-aided design (CAD) and fused deposition modeling (FDM). The modified abutment holder has a serrated handle for a firm grip and a barrel-shaped fixed portion that firmly secures the abutment. The modified holder is more secure than the conventional hexagon screwdriver. Furthermore, abutment holders can be easily manufactured by using 3D printers and repeatedly used for multiple implants restoration without substitution.
Collapse
Affiliation(s)
- Yanping Liu
- PhD candidate, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ye Lin
- Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ping Di
- Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China.
| |
Collapse
|
8
|
Design concept for preventing aspiration or ingestion of CAD-CAM crowns: A dental technique. J Prosthet Dent 2020; 123:220-222. [DOI: 10.1016/j.prosdent.2019.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 11/23/2022]
|
9
|
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.
Collapse
|
10
|
Qin H, Qing H, Hu N, Zhu H, Wang J. An All-Zirconia Crown Discovered 2 Years Following Aspiration. J Prosthodont 2017; 27:492-495. [PMID: 29143391 DOI: 10.1111/jopr.12711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2017] [Indexed: 02/05/2023] Open
Abstract
Accidental aspiration or ingestion can occur in dental treatment, as most procedures are performed with the patient in a supine position or semi-recumbent position. Aspiration of foreign bodies commonly causes acute symptoms such as violent coughing, choking, and dyspnea; however, if foreign bodies are stuck distally to the lower lobe bronchi or the bronchus intermedius, acute presentation can be rare. This clinical report documents a 68-year-old male patient who accidentally aspirated an all-zirconia crown during the try-in procedure. The case was initially surmised as ingestion. The crown remained in the lower lobe of the left lung for about 2 years without any significant symptoms. This report cautions the importance of airway protection during dental procedures.
Collapse
Affiliation(s)
- Han Qin
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hai Qing
- Department of Restorative Dentistry, Temple University Kornberg School of Dentistry, Philadelphia, PA
| | - Na Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Zhu
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Wang
- West China School of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
11
|
Endoscopic Removal of Ingested Dentures and Dental Instruments: A Retrospective Analysis. Gastroenterol Res Pract 2016; 2016:3537147. [PMID: 27738426 PMCID: PMC5055953 DOI: 10.1155/2016/3537147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/28/2016] [Indexed: 01/08/2023] Open
Abstract
Background. Dentures and dental instruments are frequently encountered ingested foreign bodies. The aim of the present study was to assess the safety and efficacy of endoscopically removing ingested dental objects. Methods. Twenty-nine consecutive patients with 29 dental objects who were treated at the Niigata University Medical and Dental Hospital from August 2009 to December 2015 were retrospectively reviewed. Characteristics of the patients and the ingested dental objects, the clinical features and findings of radiological imaging tests, and outcomes of endoscopic removal were analyzed. Results. Patients' mean age was 62.9 ± 21.0 years. The ingested dental objects included 23 dentures (13 crowns, 4 bridges, 4 partial dentures, and 2 other dentures) and 6 dental instruments. Twenty-seven upper gastrointestinal endoscopies and 2 colonoscopies were performed, and their success rates were 92.6% and 100%, respectively. There were 2 cases of removal failure; one case involved an impacted partial denture in the cervical esophagus, and this case required surgical removal. Conclusions. Endoscopic removal of ingested dentures and dental instruments is associated with a favorable success rate and acceptable complications. The immediate intervention and appropriate selection of devices are essential for managing ingested dental objects.
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
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
|
15
|
Souza FÁ, Statkievicz C, Guilhem Rosa AL, da Silveira Bossi F. Management of accidental swallowing in implant dentistry. J Prosthet Dent 2015; 114:167-70. [PMID: 25935087 DOI: 10.1016/j.prosdent.2015.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/08/2023]
Abstract
This report describes a protocol for managing the accidental swallowing of dental instruments in implant dentistry, illustrated by a patient who accidentally swallowed a hexagonal wrench. The first step was to refer the patient to the medical emergency hospital service for radiographic and clinical evaluation. The hexagonal wrench was located in the stomach and was immediately removed with an endoscopic procedure. The gastric mucosa was sampled via biopsy and the sample submitted to the urease test, which was positive for Helicobacter pylori. Triple treatment was instituted for gastritis caused by H pylori to avoid exposing the patient to unnecessary risk. Removal of a foreign body by means of an endoscopic procedure constitutes a safe and effective treatment.
Collapse
Affiliation(s)
- Francisley Ávila Souza
- Professor, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University "Júlio de Mesquita Filho" (UNESP), São Paulo, Brazil.
| | - Cristian Statkievicz
- Postgraduate student, Science of Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University "Júlio de Mesquita Filho" (UNESP), São Paulo, Brazil
| | - Ana Laura Guilhem Rosa
- Radiologist, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University "Júlio de Mesquita Filho" (UNESP), São Paulo, Brazil
| | | |
Collapse
|
16
|
Ahmed HMA, Cohen S, Lévy G, Steier L, Bukiet F. Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas. Aust Dent J 2014; 59:457-63. [PMID: 25091028 DOI: 10.1111/adj.12210] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 01/28/2023]
Abstract
Proper isolation is an essential prerequisite for successful endodontic treatment. This article aims to provide an update on the prevalence of rubber dam (RD) use, and the role of education along with attitudes of general dental practitioners (GDPs) and patients towards the application of RD in endodontics. Critical ethical issues are also highlighted. Using certain keywords, an electronic search was conducted spanning the period from January 1983 to April 2013 to identify the available related investigations, and the pooled data were then analysed. The results show that although RD is the Standard of Care in endodontic practice, there is a clear discrepancy in what GDPs are taught in dental school and what they practice after graduation. There is little scientific evidence to support the application of RD; however, patient safety and clinical practice guidelines indicate that it is unnecessary and unethical to consider a cohort study to prove what is already universally agreed upon. A few clinical situations may require special management which should be highlighted in the current guidelines. This would pave the way for clear and straightforward universal guidelines.
Collapse
Affiliation(s)
- H M A Ahmed
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | | | | | | |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
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.
Collapse
|
19
|
Abstract
The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks.
Collapse
Affiliation(s)
- Nazeer Ahmed Meeran
- Department of Orthodontics and Dentofacial Orthopedics, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India
| |
Collapse
|
20
|
Accidental ingestion of molar band and its management: maintenance is better than management. Case Rep Dent 2013; 2013:891304. [PMID: 23476819 PMCID: PMC3580915 DOI: 10.1155/2013/891304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/06/2013] [Indexed: 12/28/2022] Open
Abstract
Ingestion of a broken part of fixed orthodontic appliance is a potential complication during orthodontic treatment. We report a case of accidental ingestion of molar band and its subsequent diagnosis followed by endoscopic retrieval method. Although prevention of such incidence is the best method at the same time management of such an event is also crucial. The objective of this paper is to draw attention to the potentially serious complications that can occur if preventive techniques are not practiced and also the management of such event.
Collapse
|
21
|
|
22
|
de Souza JGO, Schuldt Filho G, Pereira Neto ARL, Lyra HF, Bianchini MA, Cardoso AC. Accident in implant dentistry: involuntary screwdriver ingestion during surgical procedure. A clinical report. J Prosthodont 2012; 21:191-3. [PMID: 22494257 DOI: 10.1111/j.1532-849x.2011.00826.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Although unusual, foreign body ingestion occurs in dentistry and may result in serious complications, such as intestinal perforation. The presence of the foreign body should be confirmed with the use of radiographs. The exam will allow the correct diagnosis and the treatment to be conducted according to the specific situation of the object in the gastrointestinal (GI) tract. The orientation of the patient as well as the awareness of the patient's medical history are key factors in preventing serious complications. Generally, instruments that enter the GI tract pass asymptomatically and atraumatically within 4 days to 2 weeks. Sometimes, a surgical approach is necessary to remove the instrument when there is bleeding, obstruction, or impaction in the GI tract. Thus, a correct diagnosis is vital to avoid unnecessary surgical interventions. The aim of this article is to report an accidental ingestion of a screwdriver by a patient who had previously undergone a hemi-mandibulectomy and its medical resolution.
Collapse
|
23
|
|
24
|
Accidental ingestion of endodontic file: a case report. Case Rep Dent 2012; 2012:278134. [PMID: 22577586 PMCID: PMC3337583 DOI: 10.1155/2012/278134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 02/20/2012] [Indexed: 11/17/2022] Open
Abstract
Ingestion of the endodontic instrument during root canal treatment is rare but can result in serious complications. The present paper reports a case in which endodontic file was accidentally swallowed by the patient undergoing root canal therapy, which entered digestive tract and passed uneventfully.
Collapse
|
25
|
|
26
|
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.
Collapse
Affiliation(s)
- Karthik Venkataraghavan
- Department of Pediatric and Preventive Dentistry, D.A. Pandu Memorial R.V. Dental College, Bangalore, India
| | | | | | | | | |
Collapse
|
27
|
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]
|
28
|
Lin HC, Pai SF, Hsu YY, Chen CS, Kuo ML, Yang SF. Use of Rubber Dams During Root Canal Treatment in Taiwan. J Formos Med Assoc 2011; 110:397-400. [DOI: 10.1016/s0929-6646(11)60058-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 04/28/2010] [Accepted: 04/29/2010] [Indexed: 10/18/2022] Open
|
29
|
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.
Collapse
Affiliation(s)
- I A Ahmad
- Private Dental Practice, Amman, Jordan.
| |
Collapse
|
30
|
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.
Collapse
Affiliation(s)
- Rhonan F Silva
- Department of Legal Dentistry/Morphology, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil.
| | | | | | | | | |
Collapse
|
31
|
Dhandapani RG, Kumar S, O'Donnell ME, McNaboe T, Cranley B, Blake G. Dental root canal treatment complicated by foreign body ingestion: a case report. CASES JOURNAL 2009; 2:117. [PMID: 19192270 PMCID: PMC2642789 DOI: 10.1186/1757-1626-2-117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 02/03/2009] [Indexed: 12/28/2022]
Abstract
Introduction Most foreign bodies pass through the gastrointestinal tract uneventfully. The majority of the reported literature describes the management of ingested blunt objects. However, ingestion of sharp objects can still occur with a higher rate of perforation corresponding to treatment dilemmas. Case Presentation We report the conservative management of an inadvertently ingested sharp foreign body during a routine dental procedure and describe a management strategy for the treatment of both blunt and sharp foreign bodies. Conclusion Urgent endoscopic assessment and retrieval is indicated when there is a history of a recently ingested sharp foreign body or if clinical suspicion suggests that the object is located within the oesophagus. Conservative management is advocated if the object has passed through the pylorus with serial clinical assessments including daily radiographs. Surgical intervention is warranted in the presence of obstruction, perforation or peritonitis.
Collapse
Affiliation(s)
- Ramyia G Dhandapani
- Department of General Surgery, Daisy Hill Hospital, Newry BT35 8DR, Northern Ireland, UK.
| | | | | | | | | | | |
Collapse
|