Restor Dent Endod.  2023 Nov;48(4):e32. 10.5395/rde.2023.48.e32.

Ingestion and surgical retrieval of an endodontic file: a case report

• Ptak DM
• Alon E
• Amato RB
• Tassinari J
• Velasquez A

• KMID: 2548753
• DOI: http://doi.org/10.5395/rde.2023.48.e32

Abstract

Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide nonsurgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist’s office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.

Keyword

Accidental injuries; Diagnostic imaging; Endoscopy; Root canal therapy; Rubber dams; Surgery

Figure

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  Figure 1 Radiographic progression of the ingested file (days 1-4). (A-C) KUB radiographs depicting the daily progression of the ingested file (red arrow) over the first 3 days of the patient’s hospitalization and (D) confirming the lack of advancement on day 4.KUB, kidney, ureter and bladder.

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  Figure 2 CT scan pinpointing the files halted location. (A-C) Slices from the computed tomography scan taken on day 3, locating the ingested file (red arrow) within the patient’s small intestine.CT, computed tomography.

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  Figure 3 Surgical retrieval of the ingested file. (A, B) Photographs from the patient’s surgery showing the abdominal incision, tissue resection and (C, D) examination of the small intestine which contained the ingested file prior to (E, F) its removal. (G, H) Additional photographs display the retrieved file.

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