Dental root elevator embedded into a subgingival caries: a case report

Abstract

BackgroundBreakage of surgical instruments is a rare complication. A mistake in operator technique or sub-standard/aged tools could lead to this type of accident. A tooth elevator is an instrument used in minor oral surgical procedures to luxate the tooth or fractured root from its socket. The authors have not found any previously published cases reporting the breakage of a tooth elevator tip which then remained as a foreign body in a hidden caries cavity.Case presentationA 28-year-old African black male was referred to a hospital in Tanzania for an intraoral radiography. The patient explained that six months previously his mandibular left third molar had been extracted. Whilst the healing process had been satisfactory, he had recently experienced acute oral pain in this region. The dental X-ray showed an image consistent with a piece of broken metal embedded in a distal subgingival caries at the mandibular left second molar.ConclusionOral and dental surgeons should take particular care when employing metal instruments with strong force in poorly visible areas. A radiographic study should be carried out when instrument breakage occurs. If an unexpected accident takes place during a surgical procedure, the patient must be informed in accordance with ethical codes, and suitable measures adopted to resolve the issue.

Computer-Controlled Local Anesthesia Complication: Surgical Retrieval of a Broken Dental Needle in Noncooperative Autistic Paediatric Patient

“…Other foreign bodies that may be encountered in the oral cavity theoretically include almost all tools used by the dentist. There are cases that describe iatrogenic breakages of dental instruments during mandibular third molar surgeries: dental root elevator embedded into a subgingival caries of second mandibular molar [ 18 ], elevator tip, broken and buried in soft tissues [ 19 ], breakage of high-speed handpiece bur [ 20 ]. Patients themselves can also place various objects in the mouth that can break, especially into the canals of the teeth, as well as into interproximal spaces.…”

Accidental High-Speed Hand Piece Bur Buried During Surgery of Mandibular Third Molar: A Rare Case Report

“…The breakage of dental instruments, like dental burs and endodontic files, because of reasons including stress, defective manufacturing, fatigue, poor handling and rust is known in dentistry. 4,5 Few papers in the literature have studied breakage of various instruments commonly used for exodontias. A more than two-year study by Yasuhara et al, 4 recorded a number of medical accidents due to defective surgical instruments.…”

“…4,5 Few papers in the literature have studied breakage of various instruments commonly used for exodontias. A more than two-year study by Yasuhara et al, 4 recorded a number of medical accidents due to defective surgical instruments. Manufacturing must be strictly controlled in medical, dental or surgical instrument manufacturing, which can result in injury to patient if they are faulty.…”

“…Minor complications can recover without any treatment, including swelling, pain or bleeding. [1][2][3][4] Accidental breakage of any of the surgical instruments is a rare surgical complication that has been reported infrequently in the Exodontia literature. The factors usually contributing to such problems are varied and can include the patient (those which are tooth related), aged instruments and the surgeon's operative experience.…”

“…The factors usually contributing to such problems are varied and can include the patient (those which are tooth related), aged instruments and the surgeon's operative experience. 1,4 Instrument breakage must be managed with a successful search for the broken fragment and its removal to avoid future potential issues like infection or any other complications including swallowing or aspiration of the fragment. 5 The aim of the present report is to describe a rare case of accidental high-speed handpiece bur buried into the mandibular bone, which remained asymptomatic for one year, until it was diagnosed during routine radiographic examination for rehabilitation of another tooth.…”