Foreign Bodies Caused by Dental Treatment in the Head and Neck - A Surgical Challenge

Abstract

Study Design Case series Objective By reporting several cases of dislocated foreign bodies, we aim to make dentists/surgeons aware of possible severe and potentially life-threatening complications. In case of dislocation, the appropriate radiological assessment depending on the foreign body is required if direct removal fails. Material and Methods Electronic and paper record of patients suffering from various dental foreign bodies were analysed. Analysis included history of dislocation, type of foreign object, anatomical region of dislocation, related dental treatment and approach to surgical removal. Results In total, 5 patients with various dental foreign body objects, including fractured root canal instruments (n = 2), a broken dental injection needle (n = 1), a broken Lindemann bur (n = 1) and root filling material (n = 1) are reported. Patient ages ranged from 14 to 54 years. In 4 cases, the foreign body could be salvaged successfully, and one patient refused the surgical therapy. General anaesthesia was required in 4 patients. Intraoperatively, a 3D C-arm was used in 3 cases to ensure the successful recovery of the foreign bodies. In 1 case, the foreign body could be removed with endoscopical assistance. Conclusion The management of dental materials and instruments requires diligent care by the practitioner, and prevention techniques should be used at all times to minimise the patients’ risk. In the case of foreign body dislocation, appropriate radiological assessment and determination of further medical treatment (if necessary) should take place. During surgical procedures, intraoperative 3D-imaging, as well as endoscopic techniques, are helpful tools to ensure the recovery of foreign bodies.