1. PATIENT PRESENTATION
A 67‐year‐old male presented to the emergency department sent from an oral surgeon's office. Patient stated that he had right‐side pleuritic chest pain after a dental procedure and suspected that he may have accidentally aspirated something. The oral surgeon arrived and stated that during a dental implant procedure, a dental implant driver became accidentally dislodged.
2. DIAGNOSIS
2.1. Dental implant driver aspiration
Chest x‐ray revealed a foreign body in the right lower bronchus or bronchus intermedius (Figures 1 and 2). The patient was intubated, and the pulmonary team performed a flexible bronchoscopy that revealed a foreign body latched in the right mainstem bronchus. Attempts at removal were unsuccessful using graspers or a basket net. The patient was transferred to another facility where the dental implant driver was ultimately removed.
FIGURE 1.
Posteroanterior chest x‐ray showing dental implant driver.
FIGURE 2.
Lateral x‐ray showing dental implant driver.
Aspiration during dental procedures is a rare, but serious complication. Aspiration cases are more critical and less common than ingestion. 1 These dental objects can come in various shapes and sizes, making removal difficult. Although foreign bodies could be located anywhere within the tracheobronchial tree, the right mainstem bronchus is the most common site due to its vertical and wider anatomical nature. Usually, patients are symptomatic with chest pain, coughing, wheezing, or stridor. If signs of airway obstruction are present, the patient should be emergently intubated. The decision for fiber‐optic versus rigid bronchoscopy is still debated, with rigid bronchoscopy usually preferred in children and flexible bronchoscopy in adults. 1 , 2
Chavda Y, Givergis R. Man with pleuritic chest pain. JACEP Open. 2023;4:e12960. 10.1002/emp2.12960
REFERENCES
- 1. Yadav RK, Yadav HK, Chandra A, Yadav S, Verma P, Shakya VK. Accidental aspiration/ingestion of foreign bodies in dentistry: a clinical and legal perspective. Natl J Maxillofac Surg. 2015;6(2):144‐151. doi: 10.4103/0975-5950.183855 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Dursun R, Oruç M, Oruç K, keksin AE, Monis S. Rare but a serious complication during dental implantation: implant aspiration. J Case Rep. 2015;5(1):68‐70. doi: 10.17659/01.2015.0017 [DOI] [Google Scholar]