Aspiration of Dislodged High Speed Dental Handpiece Turbine Head-A Case Report

牙科高速手機渦輪鬆脫誤入呼吸道－病例報告

蘇康仁(Kang Ren Soh) ； 陳遠謙(Michael Yuan-Chien Chen) ； 陸泰年(Tai-Nien Lu) ； 陳彥綦(Yan-Chi Chen)

《臺灣口腔顎面外科學會雜誌》 33卷2期 (2022/06) Pp. 117-124

摘要

Foreign body aspiration or ingestion during dental procedures is a possible complication that may be life-threatening. Dental handpiece is a mechanical device frequently used by dentists for various dental procedures, such as removing caries, polishing restorations, abutment tooth preparation or even tooth extraction. Aspiration or ingestion of dental prosthesis or even dental instruments such as surgical burs or root canal instruments have been reported in multiple articles. However, aspiration of dislodged turbine head from operating dental handpiece is extremely rare. This article presents a case of a 65-year-old female who accidentally aspirated a dislodged dental handpiece turbine head during separation of fixed prosthesis splinting upper right second premolar and first molar. An emergent chest radiograph was arranged at our emergency department. The foreign body was found in the left main bronchus and successfully retrieved via flexible bronchoscopy under conscious sedation. All dentists should be well trained and able to manage emergencies such as accidentally inspiring or swallowing instruments or materials during routine dental treatment. Precautions must be adopted to reduce the risk of all these accidents which could lead to unsalvageable iatrogenic damages. Dentists are advised to check the integrity of dental handpiece regularly for any defect or loosen parts and make sure the device worked properly before performing any routine procedure in oral cavity. Routine maintenance by manufacturer and inspection of dental handpiece before use for signs of wear or work fatigue.

關鍵字

Accidental aspiration of Foreign body ； Dental handpiece ； Bronchus ； Bronchoscopy

並列摘要

牙科治療中發生異物吞入或吸入有機會引發致命性的併發症。牙科高速手機是大部分牙科治療中不可或缺的工具，例如移除齲齒、拋光復形物、支台齒修形和拔牙等。許多文獻中皆有記載牙科治療中發生異物例如牙科鑽針或根管銼針吞入或吸入的案例。運轉中的高速手機渦輪脫落誤入呼吸道是非常罕見的案例。本文分享一例65歲女性在牙科門診接受右側上顎第二小臼齒及右側上顎第一大臼齒固定牙橋拆除過程中，高速手機渦輪鬆脫誤入支氣管的案例。病患立即被轉介到急診接受胸腔放射線檢查，確認脫落之渦輪位於左支氣管，並順利在鎮靜麻醉下經支氣管鏡將異物取出。牙醫師必需具備處理及應對在治療過程中發生異物吞入或吸入的突發狀況。此外，治療過程中也必須採取預防措施，在執行任何操作前也必須事先檢查手機的狀況，確認手機正常無異樣後，再進入口腔操作，以期盡量避免發生異物吞入消化道或誤入呼吸道，造成不必要的醫源性傷害。牙科手機也必須接受定期保養並淘汰不適用的老舊手機。

並列關鍵字

意外吸入異物 ； 牙科高速手機 ； 支氣管 ； 支氣管鏡