Aspiration of the dental crown in an elderly patient

• Main Authors: Henrique Hadad, DDS, MSc, Laís Kawamata de Jesus, DDS, MSc, Pier Paolo Poli, DDS, MSc, PhD, Idelmo Rangel Garcia-Júnior, DDS, MSc, PhD, Francisley Ávila Souza, DDS, MSc, PhD, Flávio Roberto Garbelini de Oliveira, MD, MSc, PhD
• Format: Article
• Language: English
• Published: Elsevier 2021-08-01
• Series: Radiology Case Reports
• Subjects: Dental prosthetic crown; Pulmonary aspiration; Flexible bronchoscope
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043321003368

The aspiration of objects and foreign bodies requires quick and systematic care. During emergent orotracheal intubation, accidental dental crown release can cause a threat to the patient's life. This paper aimed to report a case of foreign body (dental prosthetic crown) aspiration and its management and discuss alternative approaches. An 81-year-old male patient, who was admitted to the hospital's intensive care unit (ICU) for meningitis, presented with altered consciousness, and decreased oxygen saturation. He underwent emergent orotracheal intubation. After intubation, chest radiography was performed to check for proper orotracheal tube positioning and lung expansion. The resultant images revealed the presence of a foreign body within the right lower lobe bronchus in the shape of a dental crown. The foreign body, intubation cannula and basket clamp were successfully removed, followed by reintubation of the patient. The foreign body was a prosthetic upper premolar dental crown (24). While care should be taken to avoid complications, if a foreign body is aspirated during emergent orotracheal intubation, endoscopic removal appears safe and effective. Careful creation, placement, maintenance, and preservation of prosthetic crowns are critically important in elderly patients.