Tooth Aspiration Research Articles

A Case of Tooth Aspiration in the Left Bronchus During a Boat Trip: A Potential Life-Threatening Condition

Introduction The foreign body aspiration represents a life-threatening event, especially when huge sizes, and it is considered the most frequent cause of accidental home deaths in infancy, while uncommon in adults. Case Report Herein we describe a case of asymptomatic tooth aspiration in a 58-year-old-female undergoing chemotherapy for bowel adenocarcinoma during a boat trip. Conclusion This report highlights four important learning points: the importance of suspecting a tooth aspiration in an oncological patient during chemotherapy; the management of a potential emergency during a boat trip; the chest X Ray could be sufficient; a fibrobronchoscopy is possible even if the foreign body lies in a less accessible position.

22 - When pulmonologists are the tooth fairy: a case of tooth aspiration

22 - When pulmonologists are the tooth fairy: a case of tooth aspiration

Aspiration of deciduous tooth during elective tracheal intubation in a child: Lessons learnt.

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Unrecognized postoperative tooth aspiration

Unrecognized postoperative tooth aspiration

Suspicion of tooth aspiration during general anaesthesia in a paediatric patient – a case report

Foreign body aspiration or suspicion of it is a serious medical condition, which can cause life-threatening complications, especially in paediatric population. More than 80% of foreign body aspirations occur in children under three years of age. Children are a particularly vulnerable group due to specifi c anatomy of the airway. Symptoms of aspiration vary from suff ocation, coughing to complete absence of symptoms, which is why a diff erential diagnosis between aspiration and ingestion is sometimes very diffi cult. A six-year-old boy was admitted for elective surgery to correct vertical strabismus. At the pre-anaesthesia evaluation, the child was classifi ed as an ASA II patient, due to frequent laryngitis and bronchitis. The Mallampati score was 1 with no wobbly teeth recorded. After anaesthesia induction, the airway was secured with a laryngeal masksize 3.0 without complications. Upon awakening of the patient and removal of the laryngeal mask, blood was observed in the lodge of the lower left incisor and a lack thereof. The patient was without signs of respiratory distress. An emergency chest X-ray ruled out a foreign body in the airway, and subsequent X-rays of the abdomen revealed the presence of teeth in the projection of the stomach. The child was discharged to home care without complications. The clinical picture of foreign body aspiration under anaesthesia may be atypical and asymptomatic. Therefore, even the slightest suspicion of aspiration, especially in anaesthesia procedures, should be ruled out or confi rmed. Complications are most often the result of late-recognized aspiration.

A Case of Tooth Aspiration During Dental Extraction: Could It Be Prevented by Sedation Practices?

A Case of Tooth Aspiration During Dental Extraction: Could It Be Prevented by Sedation Practices?

Tooth Aspiration in Child during a Dental Procedure: Case Report and Review of the Literature

O bjective – The aim of this article is to illustrate the importance of a prompt evaluation of a foreign body aspiration (FBA). C ase Presentation – A 13-year old boy was admitted to hospital in 1981, one and a half month after a dental procedure of tooth extraction. The tooth was presumed to have been ingested during the procedure and the child was sent home. The symptoms presented immediately and were aggravating during the time. Before the admission to the hospital the child was examined by medical professionals on three occasions but only at hospital the FBA was suspected. During the first bronchoscopy, the foreign body had not been extracted, so the child was transferred to the referral centre where the tooth was successfully removed and he recovered. Conclusion – In the setting of dental procedure in paediatric population, the missing instrument, material or extracted tooth must be found or a foreign body aspiration and ingestion should be suspected until proven otherwise.

A Novel Proposal for Classifying Pediatric Tonsillectomy Complications: Modified Clavien Classification.

IntroductionTonsillectomy is one of the most common operations performed in the otolaryngology practice and there does not exist a systematic classification for tonsillectomy complications in the prior literature. In this study, we aimed at presenting a novel classification system to the current literature and analyzing complications of pediatric tonsillectomy based on this novel classification system.Methods A novel classification system based on modified Clavien classification was constituted for pediatric tonsillectomy complications. Medical records of 534 patients underwent tonsillectomy were retrospectively investigated and complication rates of tonsillectomy between children and adults were compared using this classificationResults In total, 454 pediatric patients (258 males and 196 females, age range = 3-17 years) who underwent cold-knife tonsillectomy were eligible for the study. To compare the complication rates of the pediatric patients with adults, 80 adults with tonsillectomy (50 males and 30 females, age range 18-46) were also included. In children, the most common complication was dehydration, seen in 13 (2.86%) patients. The most serious complication was tooth aspiration (Grade 4a), seen in only one (0.22%) patient. Fifteen (3.3%) pediatric patients experienced more than one complication. Overall complication rate of pediatric tonsillectomy was 10.13% (46 patients). In adults, the most common complication was postoperative bleeding, seen in 11 (13.75%) adult patients. The most serious complication was Grade 3a postoperative bleeding, seen in four (5%) patients. Overall complication rate of adult tonsillectomy was 21.25% (17 patients). Overall complication rate of pediatric tonsillectomy was significantly lower compared with the complication rate of adult tonsillectomy (10.13% vs. 21.25%, p = 0.004, X2 = 8.07).Conclusion Modified Clavien classification is a novel and simple tool to analyze and categorize complications of pediatric tonsillectomy.

A Rare Condition in Children: Tooth Aspiration

A Rare Condition in Children: Tooth Aspiration

Application of Intravascular Techniques to Remove a Broken Tooth from the Airways after Emergency Intubation: A Case Report

Abstract Background: Tooth aspiration is a relatively uncommon complication of endotracheal intubation. Classic methods to remove a tooth from airways may fail in some cases, even rigid bronchoscopy, which is the method of choice for the removal of tracheobronchial Foreign Bodies (FB). Endovascular treatment is a potentially efficient treatment option in such cases. Case Presentation: We report a case of a 35-year-old man who was admitted to hospital after an emergent on-street intubation with a broken tooth lodged in the distal part of the bronchial tube. A few attempts to remove the tooth with standard laryngological endotracheal equipment were unsuccessful. Conclusion: Eventually, the tooth was successfully removed by an interventional radiologist with the use of intravascular tools including a microguidewire, balloon and loop. Usage of precise endovascular devices may be applied in successful removal of teeth or other foreign bodies from the tracheobranchial tree. Keywords Interventional Radiology; Perianesthetic Dental Injury; Treatment; Tooth Aspiration

Tooth Aspiration in a Patient with Traumatic Brain Injury.

Tooth aspiration is a rare issue in the course of patients with trauma and may remain undiagnosed for a long period, resulting in delayed complications, such as atelectasis and recurrent infections. Flexible bronchoscopy is considered the preferred primary procedure for the management of airway foreign bodies in adults. However, it may cause intracranial hypertension in trauma patients with concomitant head injuries. We herein report a case of a patient with traumatic brain injury who underwent tooth aspiration using flexible bronchoscopy, with continuous monitoring of intracranial pressure (ICP). The importance of a thorough review of radiographs and chest computed tomography for foreign body aspiration in trauma patients was highlighted, particularly in a maxillofacial trauma, as tooth aspiration may remain undiagnosed for extended periods. Moreover, the difficulty in maintaining the ICP within normal limits during bronchoscopy in patients with traumatic brain injury was reinstated, and the need for continuous monitoring of the cerebral hemodynamics and harmonization was emphasized, with recommendations for bronchoscopy via an endotracheal tube.

Traumatic Tooth Aspiration: Case Report and Review of the Literature

In the setting of polytrauma, several foreign bodies could be aspirated, including avulsed teeth. Because a minimally responsive polytrauma patient could be at risk of airway compromise, emergency intubation is performed which can by itself lead to aspirated tooth. A complete dental examination is required to check for any fracture. A CT scan is the most sensitive modality for diagnosis. A rigid or flexible bronchoscopy is indicated for removal of the foreign bodies.

Neonatal tooth with Riga-Fide disease affecting breastfeeding: a case report

BackgroundNeonatal teeth erupt during the neonatal period and natal teeth are the presence of teeth since birth. While rare, natal teeth and neonatal teeth can have a significant impact on breastfeeding. Neonatal teeth are less common, and although its exact etiology is still unknown, it can cause difficulties in breastfeeding to the mother and may eventually lead to discontinuation of breastfeeding. Other associated possible complications include tooth aspiration and sublingual ulceration. This paper was aimed to discuss the clinical features, complications, and management of neonatal tooth, in addition to its impact on breastfeeding and role in sublingual ulcer formation.Case presentationWe present a baby girl who had a neonatal tooth with sublingual ulceration (Riga-Fede disease), which resulted in a difficulty to breastfeed for the baby and nipple pain to the mother. Following the extraction of the baby’s tooth, she immediately continued breastfeeding, and her tongue ulcer healed well.ConclusionExtraction of the neonatal tooth promoted rapid healing of oral ulcers and the reestablishment of breastfeeding.

義歯誤嚥によると思われる肺放線菌症の 1 例

義歯誤嚥によると思われる肺放線菌症の 1 例

Aspiration of Tooth in A Tracheotomised Patient- A Rarecase Report And Review Of Literature.

Aspiration of tooth by conscious patient is not a common occurrence in exodontia. Most cases of aspiration are secondary to maxillofacial trauma and during intubation for general anesthesia. There are isolated case reports of aspiration oftooth during extraction in pediatric age group. Here we present a case report of aspiration of tooth by a conscious tracheotomised adult patient and the difficulties encountered in retrieving the tooth along with the review of literature. Aspiration in this case can be attributed to the diminished gag and cough reflexes caused by the tracheotomy of the patient. A step by step protocol has been devised to manage such situations.

Tooth aspiration following maxillofacial trauma: Report of a rare case

Maxillofacial trauma is often associated with avulsion of teeth. Occasionally, there may be tooth aspiration either spontaneously or following intubation. We report a case of tooth aspiration in a patient of head injury and maxillofacial soft tissue injury following motor vehicle accident and have discussed regarding its incidence, sequelae, and management.

Extraction of Endobronchial Tooth by Flexible Bronchoscopy Using Fishnet Basket in Patients of Intensive Care Unit with Artificial Airway

Foreign body aspiration into the tracheobronchial tree can cause serious problems. Tooth aspiration can occur during emergency endotracheal intubation. However, removal of a tooth from the airway is difficult because of the round shape and smooth surface of the tooth. Here, I report extraction of a tooth from the airway by flexible bronchoscopy using fishnet basket in intensive care patients. The procedure was performed in six patients. All patients were critically ill with an artificial airway (n = 4; endotracheal tube, n = 2; tracheostomy tube). The tooth location was right bronchial tree in three patients and left bronchial tree in three patients. Tooth extraction failed in two patients because the teeth were impacted in the distal bronchus during bronchoscopy. There was no complication such as life threatening arrhythmia or hypoxemia during the procedure. Using flexible bronchoscopy with a fishnet basket, we were able to extract aspirated teeth from patients with an artificial airway.

레진 강선 고정을 이용한 유전치 치근 파절의 보존적 치료 : 증례 보고

유치 치근 파절의 치료는 정기 검진을 통해 관찰하거나 발치를 권유하고 있다. 특히 심한 동요도와 변위가 있는 경우 영구치 손상 가능성과 흡인의 위험성 때문에 주로 발치를 시행한다. 하지만 최근 재위치와 고정을 통한 보존적 치료가 새롭게 제시되고 있다. 이른 시기의 유전치 발치는 심미적 문제, 발음 저작 등의 기능적 문제, 공간 소실, 환아와 보호자의 심리 사회적인 문제 등 여러 가지 문제점들을 야기하므로 치근 파절된 유치를 유지하는 것만큼 좋은 치료는 없다. 이 증례 보고는 치근 파절을 보이는 두 증례의 진단, 치료, 평균 27개월의 정기 검진 자료를 토대로 심한 동요도와 변위가 있는 유치 치근 파절의 보존적인 치료 가능성을 제시하고자 하였다. 두 증례에서 발치 대신 재위치와 장기간의 레진 강선 고정을 시행하였고, 후속 영구치가 맹출 할 때까지 정기검진을 시행하였다. 정기검진과정 중에 동통, 치수괴사, 감염, 영구치 치배 변위, 맹출 이상 등의 부작용은 나타나지 않았다. In an intra-alveolar root fracture (IARF) of a primary tooth with severe mobility and displacement, extraction and periodic-follow-up is the choice of recommended treatments because of the fear of aspiration of the mobile tooth and the possibility of damage in the permanent succeeding tooth. However, repositioning and splinting are presented as a fresh proposal recently. In case of extracting a primary incisor, many problems occur; esthetic problems; functional problems such as pronunciation and mastication; space loss; and psychological and social problems. Therefore, the best treatment is conservation of the primary tooth. The aim of this report was to suggest the conservative treatment of an Intra-alveolar root fracture of the primary central incisors with severe mobility and displacement based on two cases that describe the diagnoses, treatments and follow-ups (mean period: 27-month). All cases have been treated by reduction and immobilization by resin wire splint (RWS) (mean period: 6-week). Both cases were followed up until the successors were erupted. There have been no complications such as pain, pulp necrosis, periapical lesion, displacement of permanent tooth germ, eruption disturbance and etc.

18-Gauge Needle Cap as Adjunct to Prevent Kinking of Endotracheal Tube

A self-retaining Dingman mouth retractor is widely used to keep the mouth open during cleft palate and intraoral surgery. The airway is at risk of being crushed or occluded as the gag (tongue plate) of the Dingman mouth retractor is being pushed against the endotracheal tube.Kinking of the endotracheal tube between the teeth and Dingman mouth retractor has been reported even with the oral Ring-Adair-Elwyn or flexometallic or armored endotracheal tubes. To minimize kinking of the endotracheal tube and its consequent complications, we routinely insert an 18-gauge needle cap at the potential space between the teeth and the tongue plate (gag) of the Dingman mouth retractor, which is situated lateral to the endotracheal tube. In our experience of approximately 5000 intraoral cases using a Dingman mouth retractor and 18-gauge needle cap, we have not had any tooth avulsion or aspiration of the 18-gauge foreign body while maintaining a consistent and secured airway during cleft palate and intraoral surgery.

“Stuck”: Removal of Embedded Distal Airway Foreign Bodies

Objective: 1) Describe a novel technique for removal of embedded distal airway foreign bodies. 2) Apply the proximal endoscopic balloon dilation technique for removal of embedded distal airway foreign bodies in 2 patients. 3) Discuss the evolution, operative considerations, and future applications of the technique Method: Report of 2 cases in 2011. Condition studied: Embedded, symptomatic distal airway foreign bodies. Subjects studied: Pediatric airway patients. Setting: Tertiary care pediatric hospital. Intervention: Rigid bronchoscopy with endoscopic balloon dilation of the proximal bronchial segment to facilitate access to the foreign body. Outcomes: Successful foreign body removal. Results: Case 1: A 23-month-old patient with recurrent pneumonia. Rigid bronchoscopy showed a cashew piece in the distal airway with proximal edema preventing removal. Dilation of the proximal bronchial segment with a Fogarty catheter allowed for access and removal with optical forceps. Case 2: Two-year-old unrestrained passenger in a motor vehicle accident with tooth aspiration causing intermittent respiratory distress. At bronchoscopy, the tooth was in the distal airway and embedded in granulation tissue which prevented removal. A Fogarty catheter was used to dilate the bronchial segment proximal to the foreign body which was then removed with optical forceps. Conclusion: Embedded airway foreign bodies are associated with edema and granulation tissue which may prevent removal due to proximal airway narrowing. We present a novel technique using a Fogarty balloon catheter to dilate the airway proximal to the foreign body. This allows for removal of otherwise stuck distal airway foreign bodies.