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Management of implant screwdriver ingestion: reflection and guidance for the GDP placing implants Rupert Mazareanu Naveed Soomro Shihab Romeed Dental Update 2024 50:1, 707-709.
Dental procedures carry a risk of inhalation or ingestion of foreign bodies. The Medical Defence Union reported there were 141 dentistry-related incidents over a 10 year period (137 ingestion, four aspiration). Most objects pass through the alimentary canal uneventfully, but timely and efficient management can reduce the risk of complications. This article reflects on the management following accidental ingestion of an implant screwdriver in an oral reconstruction patient. Clear step-by-step guidance for the GDP performing implant therapy is provided.
CPD/Clinical Relevance: Through reflection on a clinical incident of ingestion and aspiration of a foreign body, the lessons learned are shared to aid in avoidance of such situations, or their effective management.
Article
Procedures involving fixed prosthodontics have the greatest risk of aspiration or ingestion. Before embarking on oral rehabilitation, the clinician must carry out a comprehensive assessment and take the necessary intra-operative precautions to mitigate the risk of foreign body ingestion/inhalation.1 However, if one of these adverse events occurs, prompt and proper management can help to improve outcomes and reduce litigation.2
Most (80%) ingested foreign bodies pass spontaneously. Fortunately, mortality rates are low, with no death reported in a study of 852 adults. Foreign body impaction tends to occur at areas of anatomical aberrations and pathological changes.3
A 91-year-old lady was diagnosed with T4N0M0 squamous cell carcinoma (SCC) of the left buccal mucosa with mandibular involvement. This was treated surgically in October 2018 with a left segmental mandibulectomy, neck dissection and fibula free flap. She was then referred to the restorative dentistry team for oral rehabilitation to improve her quality of life in relation to nutrition and digestive problems.
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