El Wazani B, Nixon P, Butterworth C J
Liverpool University Dental Hospital, Pembroke Place, Liverpool, Merseyside, L3 5PS, UK.
Regional Maxillofacial Unit, Aintree University Hospitals NHS Foundation Trust, Aintree, Liverpool, L9 7AL, UK.
Eur J Prosthodont Restor Dent. 2018 Nov 29;26(4):184-189. doi: 10.1922/EJPRD_01800ElWazani06.
Head and neck oncology patients are high risk for ingestion or aspiration of dental instruments during treatment, due to altered anatomy and sensation. This article describes a case report of accidental ingestion of an implant screwdriver during the prosthetic phase of oral rehabilitation of a 79 year old oncology patient. The management protocol is described which included referral to the medical Accident and Emergency department, where the object was safely removed from the stomach via endoscopy. A review of similar cases of ingestion/inhalation in the literature suggests implant screwdrivers should be retrieved as safe passage through the gastrointestinal system is not assured. Awareness of the medical history and risk factors should alert clinicians to be extra cautious, and preventative strategies should be implemented at all times. Preventative measures include ligation of instruments with floss/suture material, treatment in a more vertical position, and use of rubber dam where possible.
由于解剖结构和感觉改变,头颈肿瘤患者在治疗期间有摄入或误吸牙科器械的高风险。本文描述了一例79岁肿瘤患者口腔修复假体阶段意外摄入种植体螺丝刀的病例报告。文中介绍了处理方案,包括转诊至医院急诊科,通过内窥镜从胃中安全取出异物。对文献中类似摄入/吸入病例的回顾表明,由于不能确保种植体螺丝刀能安全通过胃肠道,因此应将其取出。了解病史和风险因素应提醒临床医生格外谨慎,并应始终实施预防策略。预防措施包括用牙线/缝合材料结扎器械、在更垂直的位置进行治疗以及尽可能使用橡皮障。