|Year : 2018 | Volume
| Issue : 1 | Page : 30-31
An unusual foreign object in a tooth
Treville Pereira, Subraj Shetty
Department of Oral and Maxillofacial Pathology and Microbiology, D Y Patil University School of Dentistry, Navi Mumbai, Maharashtra, India
|Date of Web Publication||22-Jan-2018|
Department of Oral and Maxillofacial Pathology and Microbiology, D Y Patil University School of Dentistry, Sector 7, Nerul, Navi Mumbai - 400 706, Maharashtra
Source of Support: None, Conflict of Interest: None
In dental practice, discovery of a foreign body entrapped within the root canal is not uncommon. The foreign object may have been accidently lodged due to traumatic injury, iatrogenically during treatment or it may be a self-inflicted injury. The patient usually reports only when he/she experiences pain and then the foreign object is discovered in radiographic examination. In this article, we present a case report of a 43-year-old woman with a staple pin lodged in a permanent maxillary first molar.
Keywords: Foreign body, molar, staple pin, unusual object
|How to cite this article:|
Pereira T, Shetty S. An unusual foreign object in a tooth. Niger J Gen Pract 2018;16:30-1
| Introduction|| |
The lodgment of foreign bodies such as metal screws, pins, darning needles, pencil leads, and beads  in the exposed pulp cavities of carious or traumatically injured deciduous  and permanent teeth has been reported. In the literature, these cases are most often diagnosed accidentally on radiographic examination of the tooth, which may be associated with pain, swelling, infection, and recurrent abscesses as sequelae to the pulpal exposure and lodgment of the foreign body.
Clinical and radiographic examinations are essential to confirm the presence, location, size, and the type of the foreign object. The present case focuses on a foreign object found within the pulp chamber of the permanent maxillary first molar.
| Case Report|| |
A 43-year-old female patient reported to our private dental clinic at Airoli, Navi Mumbai, India, with the complaint of pain and swelling in relation to her upper right posterior teeth. The patient reported a history of pain of 1 week duration and an associated swelling for the last 3 days. The patient's medical, family, and social histories were noncontributory.
On clinical examination, the maxillary right first molar was grossly decayed and had an exposed pulp chamber. The patient reported a history of endodontic treatment of the same tooth 5 years ago. However, after endodontic treatment, the patient did not follow-up for prosthetic rehabilitation due to financial constraints. Intraoral periapical radiograph of the tooth revealed a radiopaque object resembling a twisted metal wire lodged in the pulp chamber and the distobuccal root canal of 16. There was some remnant of sealer cement in the pulp chamber and a hanging Gutta-percha cone in the mesiobuccal canal and obturated palatal canal [Figure 1]. Treatment plan involved removal of the radiopaque object, root canal treatment, and post and core followed by fabrication of coronal prosthesis. However, the patient could not afford the expensive treatment and opted for tooth extraction. The patient's consent was obtained and the tooth was extracted under local anesthesia. The foreign object was retrieved from the canal, which was found to be a staple pin [Figure 2]. On questioning the patient, she reluctantly agreed that she had placed the object to remove food particles and to get relief from pain.
|Figure 1: Intraoral periapical radiograph of the tooth showing a radiopaque object resembling a twisted metal wire lodged in the pulp chamber|
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| Discussion|| |
Dental treatment is commonly associated with foreign objects such as restorative materials, obturating materials, and fractured instruments being unintentionally impacted in the root canal system and the periapical area. Numerous instances of self-inflicted injuries leading to foreign bodies being lodged in the root canal have also been reported. Harris  reported the placement of various objects such as pencil tip, wooden tooth pick, pins, plastic objects, and toothbrush bristles in root canals of anterior teeth. Grossman and Heaton have reported cases on retrieval of pencil tips, toothpick, absorbent paper point, and tomato seed from the root canal system.,
These objects may get wedged within the canal and may be pushed further periapically. The foreign body acts as a focus for infection and may cause tissue irritation. Food impaction could be one of the reasons for patients to insert objects into teeth, which becomes a habit over a period of time.
McAuliffe has suggested various radiographic methods such as Parallax views, vertex occlusal views, triangulation techniques, stereoradiography, and tomography for localization of radiopaque foreign objects. Steiglitz forceps are used for removal of silver points from the root canal. There is a description of an assembly of a disposable injection needle and thin steel wire loop, formed by passing the wire through the needle being used. This assembly was used along with a mosquito hemostat to tighten the loop around the object., In the present case, due to financial reasons, the patient was not willing to undergo the recommended treatment. The patient was advised against using foreign objects for removing impacted food in the future. The patient was also educated about the role of foreign objects as potential sources of infection.
| Conclusion|| |
Foreign bodies may be entrapped within the root canal system of a tooth due to self-inflicted injury or iatrogenically. This may lead to complications at a later date. Patients usually do not seek treatment as long as the tooth is asymptomatic. Proper counseling is required to ensure that dental treatment is provided at the earliest to avoid further complications.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]