Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle

Stein, Kyle

doi:10.1016/j.joms.2015.04.033

Cited by 35 publications

(27 citation statements)

References 7 publications

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“…The third strategy is to position the mandible in a reproducible posture or a defined position against the maxilla, using an occlusion splint. Although artificial fixation of the mandible via a template appears to introduce no additional error, this strategy is sensitive to the relative movement of the mandible, which in turn reduces the accuracy of the navigation system [21]. …”

Section: Discussionmentioning

confidence: 99%

Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report

et al. 2017

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BackgroundA fracture of root canal instruments, with a fractured piece protruding beyond the apex, is a troublesome incident during an endodontic treatment. Locating and retrieving them represents a challenge to maxillofacial surgeons because it is difficult to access due to the proximity between the foreign body and vital structures. Although safe and accurate for surgery, radiographs and electromagnetic devices do not provide a precise three-dimensional position. In contrast, computer-aided navigation provides a correlation between preoperatively collected data and intraoperatively encountered anatomy.However, using a navigation system for mandible treatment is difficult as the mobile nature of the mandible complicates its synchronization with the preoperative imaging data during surgery.Case presentationThis report describes a case of a dental instrument breakage in the mandible during an endodontic treatment for a restorative dental procedure in a 65-year-old Japanese woman. The broken dental instrument was removed using a minimally invasive approach with a surgical navigation system and an interocclusal splint for a stable, identically repeatable positioning of the mandible. Using the three-dimensional position of the navigation probe, a location that best approximated the most anterior extent of the fragment was selected. A minimally invasive vestibular incision was made at this location, a subperiosteal reflection was performed, and the foreign body location was confirmed using a careful navigation system. The instrument was carefully visualized and extruded from the apical to the tooth crown side and was then removed using mosquito forceps through the medullary cavity of the crown side of the tooth. Follow-up was uneventful; her clinical course was good.ConclusionsThe use of a surgical navigation system together with an interocclusal splint enabled the retrieval of a broken dental instrument in a safe and minimally invasive manner without damaging the surrounding vital structures.

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Section: Discussionmentioning

confidence: 99%

Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report

et al. 2017

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“…The appropriate strategy was the key of the treatment in this case, and effective methods were also important. Application of a computer‐assisted navigation system to locate and retrieve foreign bodies in maxillofacial surgery has been reported widely , so it is not a new technique. It is helpful in identifying the location of the foreign body, determining the optimal approach, and eventually developing the surgical invasion strategy .…”

Section: Discussionmentioning

confidence: 99%

“…Compared with other localizing modalities, the use of surgical navigation can help decrease intra‐operative time, minimize dissection, and reduce post‐operative recovery time . In addition, the patient is not subjected to any intra‐operative radiation exposure . Recently, a surgical navigation system combined with endoscopy was adopted to remove foreign bodies in oral–maxillofacial regions, aiming to reduce damage to the surrounding tissues and to lower the risks .…”

Section: Discussionmentioning

confidence: 99%

“…As computer‐assisted navigation technology is applied in maxillofacial surgery, it has proven to be a useful planning and targeting tool for the removal of foreign bodies in the head and neck area . However, most reports in this field have only dealt with a single foreign body . In particular, when a large number of foreign bodies are located in the maxillofacial region, the removal procedure may encounter the risk of error, such as missing some of the foreign bodies.…”

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Removal of a large number of foreign bodies in the maxillofacial region with navigation system

Yang

et al. 2017

Dental Traumatology

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The removal of a large number of foreign bodies in the maxillofacial region can be complicated and challenging. In this case report, a specific strategy for removal of multiple foreign bodies in the maxillofacial region is presented. A girl diagnosed with 24 foreign bodies in her left lower face and neck underwent the surgery using a computer-assisted navigation system. A specific strategy was used in this case, which included from one sub-region to the next and from the easiest to the most difficult. This strategy is recommended for the removal of a large number of foreign bodies in the maxillofacial region with a navigation system.

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“…Низкие прочностные характеристики не позволяют использовать их для проводниковой анестезии ввиду опасности перелома, что указано в инструкциях к применению карпульных игл. Это подтверждается случаями перелома иглы во время анестезии у стоматолога, где в большинстве своем использовали иглы 30G [2,4,7,9,[11][12][13][14][15][16][17][18]. Стоит отметить, что в XX веке случаи перелома иглы возникали значительно реже, что связано с использованием игл большего диаметра -от 35G (0,5 мм) и выше.…”

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Needle fractures during mandibular block: prevention and emergency care algorithm

Kuzin

Гурин

Щербаков³

2018

Stomat.

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Cases of dental needle fracture during mandibular block were studied in the last 10 years. Despite dental anesthesia development, the cases of needle fracture occur regularly in the world practice. Some of these complications has iatrogenic nature while others may be attributed to independent reasons like patients' sharp movement and needle manufacturing defect. In most of the cases the needle migrates to surrounding anatomical spaces making operative removing a challenging task. Subsequent surgical removing of a foreign body has severe consequences to patient in the form of a large operating injury, long-term disability and functional limitations. The article presents an algorithm for prevention and emergency care for a patient with dental needle fracture during mandibular block.

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Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle

Cited by 35 publications

References 7 publications

Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report

Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report

Removal of a large number of foreign bodies in the maxillofacial region with navigation system

Needle fractures during mandibular block: prevention and emergency care algorithm

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