Foreign body in the region of the lower third molar: case report
DOI:
https://doi.org/10.29166/odontologia.vol22.n2.2020-108-118Keywords:
Third molar, intraoperation complications, postoperative complications, diagnostic imaging, tomography, oral surgeryAbstract
Rotating instrument fracture is a rare trans-operation complication in third molar surgery. When it goes unnoticed, its diagnosis as a foreign body is usually a radiographic finding and its extraction requires careful evaluation. A clinical case of a 21-year-old female patient is presented, who comes to the Surgery service of the Faculty of Dentistry of the Central University of Ecuador (FOUCE), referred by the radiographic finding of a foreign body in the left posterior jaw, the history refers to the extraction of lower third molars 5 years ago; without clinical signs on intraoral examination, in the radiographic study the presence of a radiopaque shadow was observed in the distal part of dental organ # 37, confirmed on tomography as an image compatible with a fractional drill between the active and passive parts. The diagnosis was of an intra-osseous foreign body placed and divided into 2 fragments. The treatment consisted of the excision of the passive part of the drill; it was decided not to extract the active part located below the nervous-vascular package, due to the risk of injury to the lower dental nerve. In the post-operation period, clinical, radiographic and tomographic controls were performed, no complications were observed, the patient remained asymptomatic and stable.
Downloads
References
Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. Journal of Oral and Maxillofacial Surgery. 2003 Dec 1;61(12):1379-89.
Escoda, Cosme Gay, and Leonardo Berini Aytés. Tratado de cirugía bucal. Ergon, 2015.
Restrepo L, Meneses F VA. Complicaciones quirúrgicas y posquirúrgicas en la exodoncia de terceros molares inferiores: estudio retrospectivo. Medicina (B Aires). 2019;6(1):3-11.
Vallejos B-A, Espinoza AM. Frecuencia de complicaciones post exodoncia simple. Oral. 2012;13(42):906-12.
Bachmann H, Cáceres R, Muñoz C, Uribe S. Complicaciones en Cirugía de Terceros Molares entre los Años 20072010, en un Hospital Urbano, Chile. Int J Odontostomatol. 2014;8(1):107-12.
Schwartz-Arad D, Lipovsky A, Pardo M, Adut O, Dolev E. Interpretations of complications following third molar extraction. Quintessence International. 2018 Jan 1;49.
Yalcin S, Aktas İ, Emes Y, Atalay B. Accidental displacement of a high-speed handpiece bur during mandibular third molar surgery: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2008 Mar 1;105(3):e29-31.
Faura Solé M, Sánchez Garcés MÁ, Berini Aytés L, Gay Escoda C. Cuerpos extraños introducidos yatrogénicamente en los tejidos bucales durante tratamientos odontológicos. A propósito de 9 casos. RCOE, Rev Ilus Cons Gen Col Odontól Estomatól Esp. 2000;5(1):55-63.
Pogrel A. Broken Local Anesthetic Needles: A Case Series of 16 Patients, With Recommendations. Journal of the American Dental Association, vol. 140, issue 12 (2009) pp. 1517-1522
Pitekova L, Satko I, Novotnakova D. Complications after third molar surgery. Bratisl Lek Listy. 2010;111(5):296-8.
Balaji SM. Burried broken extraction instrument fragment. Annals of maxillofacial surgery. 2013 Jan;3(1):93.
Mishra R, Deepak Yadav, Laxmi Kandel, Shashank Tripathi, Case report: An unusual case of buried broken exodontia instrument in inferior alveolar canal. Journal of Chitwan Medical College 2019;9(30):78-80 Available online at: www.jcmc.cmc.edu.np.
Cho H, Lynham AJ, Hsu E. Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Australian dental journal. 2017 Dec;62(4):412-9.).
Ramos E, Santamaría J, Santamaría G, Barbier L, Arteagoitia I. Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis. Oral surgery, oral medicine, oral pathology and oral radiology. 2016 Oct 1;122(4):403-25.
Pierro VS, de Morais AP, Granado L, Maia LC. An unusual accident during a primary molar extraction. J Clin Pediatr Dent. 2010;34(3):193‐195. doi:10.17796/jcpd.34.3.926lmkk762556324.
Reyes J VA. Uso de la pieza de mano de alta velocidad en cirugía bucal. 2000;38-42.
Tamashiro Higa T, Arias Inclán P. Iatropatogenia en la extracción de retenciones dentarias. Rev ADM. 2003;60:29-33.
Lacasa JM, Jiménez JA, Ferrás V, Bossom M, Sóla-Morales O, García-Rey C. Prophylaxis versus pre-emptive treatment for infective and inflammatory complications of surgical third molar removal: a randomized, double-blind, placebo-controlled, clinical trial with sustained release amoxicillin/clavulanic acid (1000/62.5 mg) Int J Oral Maxillofac Surg. 2007;36:321–7.
Lang MS, Gonzalez ML, Dodson TB. Do antibiotics decrease the risk of inflammatory complications after third molar removal in community practices?. Journal of Oral and Maxillofacial Surgery. 2017 Feb 1;75(2):249-55.
