一名静脉注射镇静剂的患者在牙周手术过程中意外摄入牙齿物体：病例管理。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Advances in Periodontics Pub Date : 2022-09-17 DOI:10.1002/cap.10225

Ebrahim Dastouri, Teresa Y. Heck, Hom-Lay Wang

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引用次数: 1

摘要

简介：异物吸入（FBA）和摄入（FBI）是世界各地牙科诊所每年发生的罕见但严重的事件。此类事件可能会对牙科临床医生和患者产生重大的医疗、法律和经济后果。通过介绍这一案例研究，我们旨在强调此类事件的适当管理和可能的后遗症。方法和结果：一位72岁的女性接受了静脉镇静的牙科手术。在牙科治疗过程中，一个牙钻被意外误食。患者被迅速转诊到一家紧急护理诊所，在那里连续几天拍摄了腹部X光片，以追踪bur通过消化系统的过程。手术成功，无并发症。结论：及时管理和转诊牙科FBA和FBI病例，然后成功检索对象，可以简单地解决该事件。要点：为什么这个案例是新信息？本案例介绍了FBA和FBI的正确管理，特别是对于需要立即采取行动缓解和预防严重并发症的静脉注射镇静剂的患者。成功管理此案的关键是什么？如何减轻联邦调查局和联邦调查局的风险？使用喉塞或橡胶屏障有助于防止异物吸入和摄入。当器械在体内使用时，将牙线固定在器械和物体上。（具体而言，用于植入导销和植入螺丝刀。）在支架放置、正畸矫治器调整以及植入牙冠的拧紧或粘接过程中，使用纱布垫或橡胶坝等屏障将口咽与口腔彻底隔离。应通过结扎将短植入物和超短植入物连接到植入物手柄上。在这种情况下，成功的主要限制是什么？缺少喉塞未能确认刺针与手柄的连接患者的解剖结构（多余结肠）阻止了刺针的自然排出。

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Accidental ingestion of a dental object during a periodontal surgical procedure on an IV sedated patient: Case management

Introduction

Foreign-body aspiration (FBA) and ingestion (FBI) are rare but serious events that occur in dental offices throughout the world every year. Such events can have significant medical, legal, and financial consequences for both the dental clinician and the patient. By presenting this case study, we aim to highlight the proper management and possible sequelae of such an event.

Methods and Results

A 72-year-old woman underwent a dental procedure with intravenous sedation. In the process of dental treatment, a dental bur was accidentally ingested. The patient was promptly referred to an urgent care clinic, where serial abdominal radiographs were taken over several days to track the course of the bur through the digestive system. The bur was successfully removed without complication.

Conclusion

Prompt management and referral of dental FBA and FBI cases, followed by successful object retrieval, lead to uncomplicated resolution of the event.

Key points

Why is this case new information?

This case presents the proper management of the FBA and FBI, particularly for IV sedated patients who require immediate action to mitigate and prevent serious complications.

What are the keys to the successful management of this case and how can the risk of FBA and FBI be mitigated?

The use of throat packs or rubber dams helps prevent foreign body aspiration and ingestion.
Attaching floss to appliances and objects when appliances are used intraorally. (Specifically, to implant guide pins and implant screwdrivers.)
Thorough isolation of the oropharynx from the mouth using a barrier, such as a gauze pad or rubber dam, during bracket placement, orthodontic appliance adjustment, and screwing or cementing of implant crowns
Short and extra short implants should be connected by ligature to the implant handpiece.

What are the primary limitations to success in this case?