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Implant screwdriver aspiration during dental procedure at a geriatric patient: a case report

Year 2022, Volume: 61 Issue: 1, 111 - 114, 15.03.2022

Selin Kenç , Gözde Işık , Tayfun Günbay , Seda Kahraman Ferit Çelik

https://doi.org/10.19161/etd.1086254

Abstract

The aim of this case report is to present a geriatric patient who had aspirated an implant screwdriver. An 82-year-old male patient involuntarily closed his mouth during the healing cap placement phase of implant treatment, and the implant screwdriver disappeared through the pharynx. As the patient exhibited no signs of airway obstruction, it was considered that the implant screwdriver might have passed into the gastrointestinal tract. However, no foreign object was detected in the esophageal mucosa. Therefore, the procedure was repeated using C arm fluoroscopy for guidance. The examination revealed the presence of the implant screwdriver in the bifurcation of the left lower lobe bronchus, which was confirmed by posterior-anterior chest radiography. The following day, the patient underwent a flexible bronchoscopy, however the screwdriver could not be retrieved during the procedure. Further treatment was refused by the patient. After one month, the implant screwdriver was expelled through the gastrointestinal tract. At the three-year follow-up, there was no evidence of a late complication. Aspiration of screwdrivers and treatment failures of these complications are reported a small number of cases in the geriatric patients. Therefore, documentation of the rare cases is necessary to provide valuable information.

Keywords

Geriatric dentistry implant screwdriver aspiration fluoroscopy bronchoscopy

References

  • Kim E, Noh W, Panchal N. Mortality from an aspiration of dental crown during extraction. Gerodontology. 2017; 34 (4): 498–500.
  • Hou R, Zhou H, Hu K et al. 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 22; 12: 23.
  • Cossellu G, Farronato G, Carrassi A, Angiero F. Accidental aspiration of foreign bodies in dental practice:clinical management and prevention. Gerodontology. 2015; 32 (3): 229–33.
  • Bergermann M, Donald PJ, aWengen DF. Screwdriver aspiration. A complication of dental implant placement. Int J Oral Maxillofac Surg. 1992; 21 (6): 339-41.
  • Lin L, Lv L, Wang Y, Zha X, Tang F, Liu X. The clinical features of foreign body aspiration into the lower airway in geriatric patients. Clin Interv Aging. 2014; 9: 1613–18.
  • Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F. Foreign body aspiration in adult airways: therapeutic approach. J Thorac Dis. 2017; 9 (9): 3398-409.
  • Kim A, Ahn KM. Endoscopic removal of an aspirated healing abutment and screwdriver under conscious sedation. Implant Dent. 2014; 23 (3): 250-2.
  • PIovino P, Di Sarno A, De Caro V, Mazzei C, Santonicola A, Bruno V. Screwdriver Aspiration During Oral Procedures: A Lesson for Dentists and Gastroenterologists. Prosthodontics. 2020; 1: 61-8.
  • Batra H, Yarmus L. Indications and complications of rigid bronchoscopy. Expert Rev Respir Med. 2018; 12 (6): 509-20.
  • Fang YF, Hsieh MH, Chung FT et al. Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults. PLoS ONE. 2015; 13; 10 (3):e0118993

Geriatrik hastada dental uygulama esnasında implant anahtarının aspirasyonu: vaka raporu

Year 2022, Volume: 61 Issue: 1, 111 - 114, 15.03.2022

Selin Kenç , Gözde Işık , Tayfun Günbay , Seda Kahraman Ferit Çelik

https://doi.org/10.19161/etd.1086254

Abstract

Bu vaka raporunun amacı, implant anahtarını aspire etmiş geriatrik bir hastayı sunmaktır. Seksen iki yaşında erkek hasta, implant tedavisinin bir aşaması olan iyileşme başlığının takılması esnasında istemsizce ağzını kapatmış ve implant anahtarı farinkse doğru yer değiştirmiştir. Hastada hava yolu tıkanıklığı bulguları olmadığı için, implant anahtarının gastrointestinal yolağa doğru hareket ettiği düşünülmüştür; ancak özefageal mukozada yabancı cisim saptanmamıştır. Bu nedenle, uygulama C arm floroskopi rehberliğinde tekrarlanmıştır. Değerlendirmede implant anahtarının sol alt lob bronş girişinde olduğu düşünülmüştür ve bu bulgu, posteroanteriyor göğüs radyografisi ile doğrulanmıştır. Takip eden günde, hasta fiberoptik fleksibl bronkoskopiye alınmıştır; ancak implant anahtarı çıkartılamamıştır. İmplant anahtarının çıkarılmasında yaşanılan başarısızlıktan dolayı, hasta tarafından ileri tedaviler reddedilmiştir. Bir ay sonra, implant anahtarı gastrointestinal yolaktan atılmıştır. Üç yıllık takipte, geç dönem komplikasyon ile karşılaşılmamıştır. Geriatrik hastalarda, implant anahtarının yutulması ve bu komplikasyonun tedavisindeki başarısızlıklar az sayıda vaka raporunda bildirilmiştir. Bu nedenle, bu nadir vakaların belgelenmesi, faydalı bilgilerin sağlanması açısından gereklidir.

Keywords

Geriatrik diş hekimliği implant anahtarı aspirasyon floroskopi bronkoskopi

References

  • Kim E, Noh W, Panchal N. Mortality from an aspiration of dental crown during extraction. Gerodontology. 2017; 34 (4): 498–500.
  • Hou R, Zhou H, Hu K et al. 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 22; 12: 23.
  • Cossellu G, Farronato G, Carrassi A, Angiero F. Accidental aspiration of foreign bodies in dental practice:clinical management and prevention. Gerodontology. 2015; 32 (3): 229–33.
  • Bergermann M, Donald PJ, aWengen DF. Screwdriver aspiration. A complication of dental implant placement. Int J Oral Maxillofac Surg. 1992; 21 (6): 339-41.
  • Lin L, Lv L, Wang Y, Zha X, Tang F, Liu X. The clinical features of foreign body aspiration into the lower airway in geriatric patients. Clin Interv Aging. 2014; 9: 1613–18.
  • Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F. Foreign body aspiration in adult airways: therapeutic approach. J Thorac Dis. 2017; 9 (9): 3398-409.
  • Kim A, Ahn KM. Endoscopic removal of an aspirated healing abutment and screwdriver under conscious sedation. Implant Dent. 2014; 23 (3): 250-2.
  • PIovino P, Di Sarno A, De Caro V, Mazzei C, Santonicola A, Bruno V. Screwdriver Aspiration During Oral Procedures: A Lesson for Dentists and Gastroenterologists. Prosthodontics. 2020; 1: 61-8.
  • Batra H, Yarmus L. Indications and complications of rigid bronchoscopy. Expert Rev Respir Med. 2018; 12 (6): 509-20.
  • Fang YF, Hsieh MH, Chung FT et al. Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults. PLoS ONE. 2015; 13; 10 (3):e0118993
There are 10 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Selin Kenç 0000-0003-4223-5468

Gözde Işık 0000-0001-9572-3049

Tayfun Günbay 0000-0002-9685-3942

Seda Kahraman 0000-0001-6162-4878

Ferit Çelik 0000-0003-4459-7657

Publication Date March 15, 2022
Submission Date March 8, 2021
Published in Issue Year 2022Volume: 61 Issue: 1

Cite

Vancouver Kenç S, Işık G, Günbay T, Kahraman S, Çelik F. Implant screwdriver aspiration during dental procedure at a geriatric patient: a case report. EJM. 2022;61(1):111-4.
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