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Orthodontic Wire Ingestion during Treatment: Reporting a Case and Review the Management of Foreign Body Ingestion or Aspiration (Emergencies)

DOI: 10.1155/2013/426591

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Abstract:

Today orthodontic treatment is in growing demand and is not limited to a specific age or social group. The nature of orthodontic treatment is such that the orthodontic wires and appliances, which are used to apply force and move the teeth, are exposed to the oral cavity. Shaping and replacing these wires in oral cavity are the major assignments of orthodontist on appointments. Therefore, we can say that orthodontic treatment requires working with dangerous tools in a sensitive place like oral cavity which is the entrance of respiratory and digestive systems. In this paper, a case of ingesting a broken orthodontic wire during eating is reported, and also necessary remedial measures at the time of encountering foreign body ingestion or aspiration are provided. 1. Introduction Optional or accidental foreign body ingestion is common. Although in most cases these objects are excreted, in 1% of the cases, complex problems such as gastrointestinal perforation are seen [1, 2] which can sometimes lead to serious risks, including death. In the United States, 1500 people die each year due to foreign body ingestion [3, 4]. Incidence of ingesting dental materials and appliances varies in different studies. It was 3.6% to 27.7% in Tamura’s review paper, and the majority belonged to adults. Aspiration or ingestion of orthodontic appliances is less common and depends on the kind of appliance [5]. Orthodontic appliances are usually small and are difficult to use especially when covered with saliva. The risk of objects to fall back into oropharynx and ingested or aspirated is more when the patient is in supine position, and it gets worse if you break the appliance. Depending on the shape, size, and flexibility of the object, some events may have minimal risk, while some may even be fatal. Prevention is the best method, but when happened, an efficient management of the event would be critical to save the patient’s life [6]. The aim of this paper is to present a case of orthodontic wire ingestion and consequences and suggests approaches in the face of these events. 2. Case Report The patient is a 29-year-old man who had been treated at a private clinic in the city (Yazd, Iran). Nonextraction treatment plan with 0.18 Roth system (Dentaurum Germany) was accomplished for the patient, and 0.16 Ni Ti arch wire (3M Unitek) was placed, at the finishing phase, on the maxillary teeth. At this time, due to lack of patient compliance, the brackets on left first and second premolars on maxillary arch were debonded. When eating, patient noticed that a piece of wire was ingested and at

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