Kunaparaju Keerthana, Shetty Karthik, Jathanna Vinod, Nath Kartik, M Roma
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.
Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Melaka Manipal Medical College, Manipal, India.
Patient Saf Surg. 2021 Jan 5;15(1):1. doi: 10.1186/s13037-020-00273-3.
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.
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.
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.
在牙科治疗过程中意外吞入牙钻是一种罕见但可能严重的并发症。早期识别和取出异物对于防止患者出现不良后果至关重要。
一名76岁男性患者因右上后牙磨损敏感为主诉前来就诊。评估牙髓状况后，计划对该牙进行根管治疗。治疗过程中，发现牙钻从手机上滑落，患者意外吞入。吞入牙钻时患者意识清醒，呼吸正常，虽有短暂轻度咳嗽。牙科治疗立即中止，患者被送往医院急诊。通过胸部和腹部X光确认了牙钻的存在及位置，随后在全身麻醉下于同一天通过食管胃十二指肠镜检查（EGD）作为急诊手术的一部分将其取出。该病例分析再次强调了使用橡皮障和纱布屏障等物理屏障作为预防措施以防止此类事件发生的重要性。
在牙科治疗过程中，吞入器械是不确定且危险的并发症。所有牙科治疗都必须使用橡皮障等物理屏障。然而，牙医应接受良好培训以处理此类医疗紧急情况，并通过取得患者信任来安抚患者。遇到的每起事件都应详细记录，为治疗提供充分指导。这将履行牙医/临床医生的职业责任，并有助于避免可能的法律和伦理问题。本病例报告强调了在牙科治疗过程中使用物理屏障以避免医疗紧急情况的必要性。
