CLINICAL REPORT
Management of accidental swallowing in implant dentistry Francisley Ávila Souza, DDS, PhD,a Cristian Statkievicz, DDS, MSc,b Ana Laura Guilhem Rosa, MD,c and Fabrício da Silveira Bossi, MDd The number of accidents in the ABSTRACT dental office capable of placing This report describes a protocol for managing the accidental swallowing of dental instruments in the patient’s health at risk is implant dentistry, illustrated by a patient who accidentally swallowed a hexagonal wrench. The first 1 relatively low. Nevertheless, step was to refer the patient to the medical emergency hospital service for radiographic and clinical when accidents do occur, they evaluation. The hexagonal wrench was located in the stomach and was immediately removed with are generally associated with an endoscopic procedure. The gastric mucosa was sampled via biopsy and the sample submitted to the urease test, which was positive for Helicobacter pylori. Triple treatment was instituted for swallowing2 or the aspiration3 gastritis caused by H pylori to avoid exposing the patient to unnecessary risk. Removal of a foreign of foreign bodies, allergic rebody by means of an endoscopic procedure constitutes a safe and effective treatment. (J Prosthet actions to medications4 or Dent 2015;-:---) 5 dental products, or surgical 6 complications are hemorrhage, infection, intestinal obprocedures. Implant placement and restoration involve struction, and perforation.1 the handling of small components such as wrenches, If the object is aspirated, it passes through the larynx connectors, extensions, and rotary instruments that risk and trachea. This is a situation with a high risk of sufbeing accidentally aspirated or swallowed.7 Furthermore, focation.14,15 Aspirated foreign bodies tend to lodge in the contact of these instruments with saliva makes them 7-9 the right side of the main bronchus,16,17 possibly because slippery and difficult to handle. of the nature of the tracheobronchial tree anatomy.3 Swallowed foreign bodies may migrate through the Common symptoms of an aspiration are coughing, esophagus, go directly into the stomach, or pass through choking and gasping for breath, acute dyspnea, and the gastrointestinal tract. However, if the swallowed diminished respiratory sounds.14 This clinical report deobject is lodged within the esophagus, it must be scribes the endoscopic procedure used after the acciimmediately removed because the esophagus is close to dental swallowing of a foreign body. the large thoracic vessels such as the pericardium and the pleura.10 If the object has passed beyond the esophagus CLINICAL REPORT into the stomach, there is a 80% or more probability of successful progression through the gastrointestinal A 65-year-old man was receiving an implant-supported tract.11,12 The physiological peristaltic waves of the dental prosthesis for the replacement of a mandibular digestive system will cause the foreign body to be first molar tooth. During the open tray impression, a expelled in 4 to 6 days.12 However, this period may hexagonal 1.7 wrench for a torque meter (Conexão Sisextend to 14 days,1 and even 40 days.12 The symptoms temas de Prótese) became detached from the transfer suggestive of swallowing foreign bodies are dysphagia, screw after the patient vomited and was swallowed. The discomfort, and retrosternal or abdominal pain,13 and the patient was reassured and immediately taken to an
Professor, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. Postgraduate student, Science of Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. c Radiologist, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. d Private practice, São Paulo, Brazil. a
b
THE JOURNAL OF PROSTHETIC DENTISTRY
1
2
Volume
-
Issue
-
Figure 2. Posterior-anterior thorax radiograph.
Figure 1. Cervical neck radiograph.
Figure 4. Beginning of endoscopic procedure.
Figure 3. Posterior-anterior abdomen radiograph.
emergency room. Radiographs of the cervical spine, thorax, and abdomen were requested. The profile cervical radiograph showed accentuated degenerative bone alterations but no signs of compromise of the soft tissues or anything suggestive of the foreign body (Fig. 1). The thorax radiograph showed normal transparency of the pulmonary fields. No image suggestive of a radiopaque foreign body was observed (Fig. 2). The simple radiograph of the abdomen, made THE JOURNAL OF PROSTHETIC DENTISTRY
with the patient lying face up, showed a radiopaque image with an elongated morphology situated in the gastric topography and suggestive of the hexagonal wrench (Fig. 3). The first choice of treatment to remove the wrench was an endoscopic procedure. Another treatment option was clinical follow-up to wait for passage through the gastrointestinal tract. The patient was positioned lying on his left side, with a nasal catheter providing 100% oxygen (White Martins Praxair) in the ratio of 2 L/min and peripheral venous access in the right upper limb infusing a 5% glucose solution. He was sedated with 0.05 mg/kg of midazolam (Dormonid; Roche Laboratories), 0.5 mg/kg of fentanyl hydrochloride (Fentanil; Cristalia Laboratories), and 0.5 mg/kg of propofol (Diprivan 1%; AstraZeneca Laboratories). An occlusal device was placed in the patient’s oral cavity (Fig. 4), and a video gastroscope 590 WR (Fujinon Company) was introduced with free passage through the oropharynx, esophagus, and stomach. The gastric mucosa presented the usual shape, except for evidence in the antrum region of an erythematous segmental area associated with the hexagonal wrench (Fig. 5). A biopsy was performed to detect Helicobacter Souza et al
-
2015
Figure 5. Hexagonal wrench in stomach.
pylori with the urease test.18 The foreign body was then successfully removed by means of basket-type forceps (Fig. 6) for capturing foreign bodies (US Endoscopy), passing freely through the stomach, esophagus, and oropharynx until it was taken out through the oral cavity. The hexagonal wrench was removed without difficulty by means of the endoscopic procedure (Fig. 7), and the patient was discharged from hospital 2 hours later. The urease test for the diagnosis of gastritis caused by H pylori was positive. The patient was given a prescription for the oral administration of a daily triple scheme of 30 mg of lansoprazole (Lansoprazol; Medley Laboratories), 500 mg of clarithromycin (Claritromicina; Medley Laboratories), and 1 g of amoxicillin (Amoxil; GlaxoSmithKline Laboratories) for 28 days. After the 28 days, the patient returned for a new endoscopic procedure and a urease test, which was negative. DISCUSSION The patient inadvertently swallowed a short hexagonal wrench during the placement of dental implants. The diagnosis depended on radiographs of the thorax, abdomen, and cervical profile to determine the location of the foreign body. These types of radiographs are frequently sufficient to locate an object.19-21 Other reports have described patients who swallowed larger objects, such as the tip of a triple syringe,22 an orthodontic activation key,13 and even a toothbrush.9 These findings show that not only small objects may be swallowed, but larger objects too. Even though 1% of the ingested instruments may cause some type of damage to the intestinal tract,1 the perforation rate of gastric mucosa by foreign bodies considered to be sharply pointed is about 15% to 35%.12 In this regard, the hexagonal 1.7 wrench for the torque meter may be considered a sharp-pointed instrument. Previous studies have reported that 87% of instruments enter the digestive tract and 13% the respiratory Souza et al
3
Figure 6. Foreign body removed by means of basket-type forceps.
Figure 7. Hexagonal wrench removed by endoscopic procedure.
tract.13,14 The majority (80% to 90%) of objects swallowed pass through the gastrointestinal tract and are expelled through the rectum, without any need for intervention either in adults or children.1,10,12 Surgical interventions are necessary when there is bleeding, obstruction, or impaction in the gastrointestinal tract;1 this was not observed in this patient. Performing an immediate endoscopic intervention for this patient was indicated because the gastrointestinal trajectory is unpredictable and there is a risk of perforation when the foreign body passes through the duodenal curve.23,24 The success of foreign body removal from the superior portion of the digestive tract is approximately 95%.25,26 If an endoscopic procedure is necessary to remove a foreign body, performing a biopsy for a H pylori diagnosis is advisable, even without any clinical signs or symptoms of gastric erosion. These bacteria are associated with the etiology of stomach cancer.27 A considerable number of reports have described the management of patients who accidentally swallowed some type of foreign body. However, few have discussed THE JOURNAL OF PROSTHETIC DENTISTRY
4
the prevention of these complications. Some have suggested using of a rubber dam or the use of a gauze screen to protect the oropharynx as a barrier, providing instructions to the patient before the procedure, ensuring proper positioning of the patient, using powerful suction equipment, keeping a firm grip on instruments during the dental procedure, and attaching dental floss to small objects.7,28 For this patient, the use of dental floss attached to the hexagonal wrench for a torque meter could have prevented this accident. REFERENCES 1. De Souza JG, Schuldt Filho G, Pereira Neto AR, Lyra HF, Bianchini MA, Cardoso AC. Accident in implant dentistry: involuntary screwdriver ingestion during surgical procedure. A clinical report. J Prosthodont 2012;2: 191-3. 2. Kuo SC, Chen YL. Accidental swallowing of an endodontic file. Int Endod J 2008;41:617-22. 3. Adewumi A, Kays DW. Stainless steel crown aspiration during sedation in pediatric dentistry. Pediatr Dent 2008;30:59-62. 4. Haïkel Y, Braun JJ, Zana H, Boukari A, De Blay F, Pauli G. Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in a root canal sealant. J Endod 2000;26:529-31. 5. Levi L, Barak S, Katz J. Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices-a systematic review. Quintessence Int 2012;43:871-7. 6. Schwartz AB, Larson EL. Antibiotic prophylaxis and postoperative complications after tooth extraction and implant placement: a review of the literature. J Dent 2007;35:881-8. 7. Umesan UK, Chua KL, Balakrishnan P. Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice. Ther Clin Risk Manag 2012;8:245-52. 8. Mohan R, Rao S, Benjamin M, Bhagavan RK. Accidental ingestion of a barbed wire broach and its endoscopic retrieval: prevention better than cure. Indian J Dent Res 2011;22:839-42. 9. Kim IH, Kim HC, Koh KH, Kim SH, Kim SW, Lee SO, et al. Journey of a swallowed toothbrush to the colon. Korean J Intern Med 2007;22:106-8. 10. Samdani T, Singhal T, Balakrishnan S, Hussain A, Grandy-Smith S, ElHasani S. An apricot story: view through a keyhole. World J Emerg Surg 2007;2:20. 11. Smith MT, Wong RKH. Esophageal foreign bodies: types and techniques for removal. Curr Treat Options Gastroenterol 2006;9:75-84. 12. American Society for Gastrointestinal Endoscopy. Guidelines for the management of ingested foreign bodies ond food impactions. Gastrointest Endosc 2011;73:1085-91.
THE JOURNAL OF PROSTHETIC DENTISTRY
Volume
-
Issue
-
13. Monini AC, Maia LG, Jacob HB, Gandini LG. Accidental swallowing of orthodontic expansion appliance key. Am J Orthod Dentofacial Orthop 2011;140:266-8. 14. Milton TM, Hearing SD, Ireland AJ. Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management. Br Dent J 2001;190:592-6. 15. Tripathi T, Rai P, Singh H. Foreign body ingestion of orthodontic origin. Am J Orthod Dentofacial Orthop 2011;139:279-83. 16. Black RE, Johnson DG, Matlack ME. Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg 1994;29:682-4. 17. de Oliveira CF, Almeida JF, Troster EJ, Vas FA. Complications of trachoebronchial foreign body aspiration in children: report of 5 cases and review of literature. Rev Hosp Clin Fac Med Sao Paulo 2002;57:108-11. 18. Wong AS, Ching SS, Long AS. The use of a second biopsy from the gastric body for the detection of Helicobacter pylori using rapid urease test. Singapore Med J 2014;55:644-7. 19. O’Connor TE, Cooney T. Oesophageal foreign body and a double aortic arch: rare dual pathology. J Laryngol Otol 2009;123:1404-6. 20. Worthington P. Ingested foreign body associated with oral implant treatment: report of a case. Int J Oral Maxillofac Implants 1996;11:679-81. 21. Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, BenMenachem T, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011;73:1085-91. 22. Govila CP. Accidental swallowing of an endodontic instrument. A report of two cases. Oral Surg Oral Med Oral Pathol 1979;48:269-71. 23. Spitz L. Management of ingested foreign bodies in childhood. Br Med J 1971;4:469-72. 24. Suita S, Ohgami H, Nagasaki A, Yakabe S. Management of pediatric patients who have swallowed foreign objects. Am Surg 1989;55:585-90. 25. Mosca S, Manes G, Martino R, Amitrano L, Bottino V, Bove A, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy 2001;33:692-6. 26. Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc 2006;64:485-92. 27. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001;13:784-9. 28. Zitzmann NU, Elsasser S, Fried R, Marinello CP. Foreign body ingestion and aspiration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 657-60. Corresponding author: Dr Francisley Ávila Souza Department of Surgery and Integrated Clinic São Paulo State University “Júlio de Mesquita Filho” (UNESP) Araçatuba, São Paulo BRAZIL Email: [email protected] Copyright © 2015 by the Editorial Council for The Journal of Prosthetic Dentistry.
Souza et al
Management of accidental swallowing in implant dentistry Francisley Ávila Souza, DDS, PhD,a Cristian Statkievicz, DDS, MSc,b Ana Laura Guilhem Rosa, MD,c and Fabrício da Silveira Bossi, MDd The number of accidents in the ABSTRACT dental office capable of placing This report describes a protocol for managing the accidental swallowing of dental instruments in the patient’s health at risk is implant dentistry, illustrated by a patient who accidentally swallowed a hexagonal wrench. The first 1 relatively low. Nevertheless, step was to refer the patient to the medical emergency hospital service for radiographic and clinical when accidents do occur, they evaluation. The hexagonal wrench was located in the stomach and was immediately removed with are generally associated with an endoscopic procedure. The gastric mucosa was sampled via biopsy and the sample submitted to the urease test, which was positive for Helicobacter pylori. Triple treatment was instituted for swallowing2 or the aspiration3 gastritis caused by H pylori to avoid exposing the patient to unnecessary risk. Removal of a foreign of foreign bodies, allergic rebody by means of an endoscopic procedure constitutes a safe and effective treatment. (J Prosthet actions to medications4 or Dent 2015;-:---) 5 dental products, or surgical 6 complications are hemorrhage, infection, intestinal obprocedures. Implant placement and restoration involve struction, and perforation.1 the handling of small components such as wrenches, If the object is aspirated, it passes through the larynx connectors, extensions, and rotary instruments that risk and trachea. This is a situation with a high risk of sufbeing accidentally aspirated or swallowed.7 Furthermore, focation.14,15 Aspirated foreign bodies tend to lodge in the contact of these instruments with saliva makes them 7-9 the right side of the main bronchus,16,17 possibly because slippery and difficult to handle. of the nature of the tracheobronchial tree anatomy.3 Swallowed foreign bodies may migrate through the Common symptoms of an aspiration are coughing, esophagus, go directly into the stomach, or pass through choking and gasping for breath, acute dyspnea, and the gastrointestinal tract. However, if the swallowed diminished respiratory sounds.14 This clinical report deobject is lodged within the esophagus, it must be scribes the endoscopic procedure used after the acciimmediately removed because the esophagus is close to dental swallowing of a foreign body. the large thoracic vessels such as the pericardium and the pleura.10 If the object has passed beyond the esophagus CLINICAL REPORT into the stomach, there is a 80% or more probability of successful progression through the gastrointestinal A 65-year-old man was receiving an implant-supported tract.11,12 The physiological peristaltic waves of the dental prosthesis for the replacement of a mandibular digestive system will cause the foreign body to be first molar tooth. During the open tray impression, a expelled in 4 to 6 days.12 However, this period may hexagonal 1.7 wrench for a torque meter (Conexão Sisextend to 14 days,1 and even 40 days.12 The symptoms temas de Prótese) became detached from the transfer suggestive of swallowing foreign bodies are dysphagia, screw after the patient vomited and was swallowed. The discomfort, and retrosternal or abdominal pain,13 and the patient was reassured and immediately taken to an
Professor, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. Postgraduate student, Science of Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. c Radiologist, Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State University “Júlio de Mesquita Filho” (UNESP), São Paulo, Brazil. d Private practice, São Paulo, Brazil. a
b
THE JOURNAL OF PROSTHETIC DENTISTRY
1
2
Volume
-
Issue
-
Figure 2. Posterior-anterior thorax radiograph.
Figure 1. Cervical neck radiograph.
Figure 4. Beginning of endoscopic procedure.
Figure 3. Posterior-anterior abdomen radiograph.
emergency room. Radiographs of the cervical spine, thorax, and abdomen were requested. The profile cervical radiograph showed accentuated degenerative bone alterations but no signs of compromise of the soft tissues or anything suggestive of the foreign body (Fig. 1). The thorax radiograph showed normal transparency of the pulmonary fields. No image suggestive of a radiopaque foreign body was observed (Fig. 2). The simple radiograph of the abdomen, made THE JOURNAL OF PROSTHETIC DENTISTRY
with the patient lying face up, showed a radiopaque image with an elongated morphology situated in the gastric topography and suggestive of the hexagonal wrench (Fig. 3). The first choice of treatment to remove the wrench was an endoscopic procedure. Another treatment option was clinical follow-up to wait for passage through the gastrointestinal tract. The patient was positioned lying on his left side, with a nasal catheter providing 100% oxygen (White Martins Praxair) in the ratio of 2 L/min and peripheral venous access in the right upper limb infusing a 5% glucose solution. He was sedated with 0.05 mg/kg of midazolam (Dormonid; Roche Laboratories), 0.5 mg/kg of fentanyl hydrochloride (Fentanil; Cristalia Laboratories), and 0.5 mg/kg of propofol (Diprivan 1%; AstraZeneca Laboratories). An occlusal device was placed in the patient’s oral cavity (Fig. 4), and a video gastroscope 590 WR (Fujinon Company) was introduced with free passage through the oropharynx, esophagus, and stomach. The gastric mucosa presented the usual shape, except for evidence in the antrum region of an erythematous segmental area associated with the hexagonal wrench (Fig. 5). A biopsy was performed to detect Helicobacter Souza et al
-
2015
Figure 5. Hexagonal wrench in stomach.
pylori with the urease test.18 The foreign body was then successfully removed by means of basket-type forceps (Fig. 6) for capturing foreign bodies (US Endoscopy), passing freely through the stomach, esophagus, and oropharynx until it was taken out through the oral cavity. The hexagonal wrench was removed without difficulty by means of the endoscopic procedure (Fig. 7), and the patient was discharged from hospital 2 hours later. The urease test for the diagnosis of gastritis caused by H pylori was positive. The patient was given a prescription for the oral administration of a daily triple scheme of 30 mg of lansoprazole (Lansoprazol; Medley Laboratories), 500 mg of clarithromycin (Claritromicina; Medley Laboratories), and 1 g of amoxicillin (Amoxil; GlaxoSmithKline Laboratories) for 28 days. After the 28 days, the patient returned for a new endoscopic procedure and a urease test, which was negative. DISCUSSION The patient inadvertently swallowed a short hexagonal wrench during the placement of dental implants. The diagnosis depended on radiographs of the thorax, abdomen, and cervical profile to determine the location of the foreign body. These types of radiographs are frequently sufficient to locate an object.19-21 Other reports have described patients who swallowed larger objects, such as the tip of a triple syringe,22 an orthodontic activation key,13 and even a toothbrush.9 These findings show that not only small objects may be swallowed, but larger objects too. Even though 1% of the ingested instruments may cause some type of damage to the intestinal tract,1 the perforation rate of gastric mucosa by foreign bodies considered to be sharply pointed is about 15% to 35%.12 In this regard, the hexagonal 1.7 wrench for the torque meter may be considered a sharp-pointed instrument. Previous studies have reported that 87% of instruments enter the digestive tract and 13% the respiratory Souza et al
3
Figure 6. Foreign body removed by means of basket-type forceps.
Figure 7. Hexagonal wrench removed by endoscopic procedure.
tract.13,14 The majority (80% to 90%) of objects swallowed pass through the gastrointestinal tract and are expelled through the rectum, without any need for intervention either in adults or children.1,10,12 Surgical interventions are necessary when there is bleeding, obstruction, or impaction in the gastrointestinal tract;1 this was not observed in this patient. Performing an immediate endoscopic intervention for this patient was indicated because the gastrointestinal trajectory is unpredictable and there is a risk of perforation when the foreign body passes through the duodenal curve.23,24 The success of foreign body removal from the superior portion of the digestive tract is approximately 95%.25,26 If an endoscopic procedure is necessary to remove a foreign body, performing a biopsy for a H pylori diagnosis is advisable, even without any clinical signs or symptoms of gastric erosion. These bacteria are associated with the etiology of stomach cancer.27 A considerable number of reports have described the management of patients who accidentally swallowed some type of foreign body. However, few have discussed THE JOURNAL OF PROSTHETIC DENTISTRY
4
the prevention of these complications. Some have suggested using of a rubber dam or the use of a gauze screen to protect the oropharynx as a barrier, providing instructions to the patient before the procedure, ensuring proper positioning of the patient, using powerful suction equipment, keeping a firm grip on instruments during the dental procedure, and attaching dental floss to small objects.7,28 For this patient, the use of dental floss attached to the hexagonal wrench for a torque meter could have prevented this accident. REFERENCES 1. De Souza JG, Schuldt Filho G, Pereira Neto AR, Lyra HF, Bianchini MA, Cardoso AC. Accident in implant dentistry: involuntary screwdriver ingestion during surgical procedure. A clinical report. J Prosthodont 2012;2: 191-3. 2. Kuo SC, Chen YL. Accidental swallowing of an endodontic file. Int Endod J 2008;41:617-22. 3. Adewumi A, Kays DW. Stainless steel crown aspiration during sedation in pediatric dentistry. Pediatr Dent 2008;30:59-62. 4. Haïkel Y, Braun JJ, Zana H, Boukari A, De Blay F, Pauli G. Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in a root canal sealant. J Endod 2000;26:529-31. 5. Levi L, Barak S, Katz J. Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices-a systematic review. Quintessence Int 2012;43:871-7. 6. Schwartz AB, Larson EL. Antibiotic prophylaxis and postoperative complications after tooth extraction and implant placement: a review of the literature. J Dent 2007;35:881-8. 7. Umesan UK, Chua KL, Balakrishnan P. Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice. Ther Clin Risk Manag 2012;8:245-52. 8. Mohan R, Rao S, Benjamin M, Bhagavan RK. Accidental ingestion of a barbed wire broach and its endoscopic retrieval: prevention better than cure. Indian J Dent Res 2011;22:839-42. 9. Kim IH, Kim HC, Koh KH, Kim SH, Kim SW, Lee SO, et al. Journey of a swallowed toothbrush to the colon. Korean J Intern Med 2007;22:106-8. 10. Samdani T, Singhal T, Balakrishnan S, Hussain A, Grandy-Smith S, ElHasani S. An apricot story: view through a keyhole. World J Emerg Surg 2007;2:20. 11. Smith MT, Wong RKH. Esophageal foreign bodies: types and techniques for removal. Curr Treat Options Gastroenterol 2006;9:75-84. 12. American Society for Gastrointestinal Endoscopy. Guidelines for the management of ingested foreign bodies ond food impactions. Gastrointest Endosc 2011;73:1085-91.
THE JOURNAL OF PROSTHETIC DENTISTRY
Volume
-
Issue
-
13. Monini AC, Maia LG, Jacob HB, Gandini LG. Accidental swallowing of orthodontic expansion appliance key. Am J Orthod Dentofacial Orthop 2011;140:266-8. 14. Milton TM, Hearing SD, Ireland AJ. Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management. Br Dent J 2001;190:592-6. 15. Tripathi T, Rai P, Singh H. Foreign body ingestion of orthodontic origin. Am J Orthod Dentofacial Orthop 2011;139:279-83. 16. Black RE, Johnson DG, Matlack ME. Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg 1994;29:682-4. 17. de Oliveira CF, Almeida JF, Troster EJ, Vas FA. Complications of trachoebronchial foreign body aspiration in children: report of 5 cases and review of literature. Rev Hosp Clin Fac Med Sao Paulo 2002;57:108-11. 18. Wong AS, Ching SS, Long AS. The use of a second biopsy from the gastric body for the detection of Helicobacter pylori using rapid urease test. Singapore Med J 2014;55:644-7. 19. O’Connor TE, Cooney T. Oesophageal foreign body and a double aortic arch: rare dual pathology. J Laryngol Otol 2009;123:1404-6. 20. Worthington P. Ingested foreign body associated with oral implant treatment: report of a case. Int J Oral Maxillofac Implants 1996;11:679-81. 21. Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, BenMenachem T, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011;73:1085-91. 22. Govila CP. Accidental swallowing of an endodontic instrument. A report of two cases. Oral Surg Oral Med Oral Pathol 1979;48:269-71. 23. Spitz L. Management of ingested foreign bodies in childhood. Br Med J 1971;4:469-72. 24. Suita S, Ohgami H, Nagasaki A, Yakabe S. Management of pediatric patients who have swallowed foreign objects. Am Surg 1989;55:585-90. 25. Mosca S, Manes G, Martino R, Amitrano L, Bottino V, Bove A, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy 2001;33:692-6. 26. Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc 2006;64:485-92. 27. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001;13:784-9. 28. Zitzmann NU, Elsasser S, Fried R, Marinello CP. Foreign body ingestion and aspiration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 657-60. Corresponding author: Dr Francisley Ávila Souza Department of Surgery and Integrated Clinic São Paulo State University “Júlio de Mesquita Filho” (UNESP) Araçatuba, São Paulo BRAZIL Email: [email protected] Copyright © 2015 by the Editorial Council for The Journal of Prosthetic Dentistry.
Souza et al
