Private practice limited to prosthodontics, Bellevue, WA, USA.
Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA.
J Oral Implantol. 2024 Feb 1;50(1):39-44. doi: 10.1563/aaid-joi-D-22-00215.
Ingestion or aspiration of dental implant screwdrivers or implant components is potentially life-threatening. There are no reports on the frequency at which dentists drop these devices within the mouth or which components are most problematic. There are few reports on what protective measures clinicians take, where risks exist, and how this problem is managed. A 9-part questionnaire was provided to dentists. Data collected included clinicians' roles, implant surgeons, restorative clinicians, or both-the frequency of dropping implant screwdrivers or components, items considered most problematic. Patient protection and management were also requested. Finally, questions related to how much of a problem clinicians considered this to be and if further solutions and a standardized management protocol should be developed. One hundred twelve dentists voluntarily completed the survey. Of the dentists, 54% restored, 37% restored and surgically placed, and 9% solely placed implants. Twenty-nine percent claimed never to drop components, with 56% dropping an instrument less than 10% of the time. Less than half would suggest patients seek medical advice if a screwdriver or component was accidentally dropped intraorally and was not recovered. Thirty percent never tied floss tethers to screwdrivers, and a similar percentage reported they only sometimes did so. Throat pack protection was reported 51% of the time. Ninety percent considered dropping components an issue, with screwdrivers most problematic. Aspiration or ingestion of implant screwdrivers and components is problematic, with dentists varying their use of protection devices. There is a need to standardize and implement patient protection procedures and management and develop methods to reduce the risk of these potentially life-threatening issues.
将牙科植入物螺丝刀或植入物部件吞下或吸入可能会危及生命。目前尚无关于牙医在口腔内掉落这些器械的频率或哪些部件最成问题的报告。关于临床医生采取哪些保护措施、存在哪些风险以及如何处理这些问题的报告很少。向牙医提供了一份由 9 个部分组成的问卷。收集的数据包括临床医生的角色、种植外科医生、修复临床医生或两者兼而有之——掉落种植螺丝刀或部件的频率、被认为最成问题的项目。还要求患者保护和管理。最后,还询问了临床医生认为这个问题有多大以及是否应该进一步制定解决方案和标准化管理方案。112 名牙医自愿完成了这项调查。在牙医中,54%的人进行修复,37%的人进行修复和手术植入,9%的人仅植入。29%的人声称从未掉落过部件,其中 56%的人在不到 10%的时间内掉落器械。如果螺丝刀或部件意外掉入口内且未找回,不到一半的人会建议患者寻求医疗建议。只有 30%的人从不将牙线系在螺丝刀上,类似比例的人表示他们只是偶尔这样做。喉塞保护装置的报告率为 51%。90%的人认为掉落部件是个问题,其中螺丝刀最成问题。吸入或吞下植入物螺丝刀和部件是有问题的,牙医会根据需要使用保护装置。需要标准化和实施患者保护程序和管理,并开发方法来降低这些潜在危及生命问题的风险。