The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
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FOREIGN BODY INGESTION DURING DENTAL TREATMENT IN PEDIATRIC PATIENT

치과치료시 발생한 이물질 삼킴에 대한 치험례

  • Kim, Sun-Ha (Dept. of Pediatric Dentistry and Institute of Oral biology, School of Dentistry, Kyung Hee University) ;
  • Choi, Sung-Chul (Dept. of Pediatric Dentistry and Institute of Oral biology, School of Dentistry, Kyung Hee University) ;
  • Park, Jae-Hong (Dept. of Pediatric Dentistry and Institute of Oral biology, School of Dentistry, Kyung Hee University) ;
  • Kim, Kwang-Chul (Dept. of Pediatric Dentistry and Institute of Oral biology, School of Dentistry, Kyung Hee University)
  • 김선하 (경희대학교 치과대학 소아치과학교실) ;
  • 최성철 (경희대학교 치과대학 소아치과학교실) ;
  • 박재홍 (경희대학교 치과대학 소아치과학교실) ;
  • 김광철 (경희대학교 치과대학 소아치과학교실)
  • Received : 2011.06.11
  • Accepted : 2011.06.17
  • Published : 2011.06.30
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Abstract

There are a lot of dental emergency situations and accidental aspiration or ingestion of a dental instrument is one of the common accidents in dental practice especially on disabied or pediatric patient with negative behavior. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. This is a case of an accident during the treatment of a 18 months male patient with caries of anterior deciduous teeth. During the treatment, the gauze was used by waterproofing instead of a rubber dam. #4 round bur (approximately 2.2cm long) which was put on the tray was cling to the gauze and the bur was fell into the patient's throat. The bur was 2.2cm long and very sharp so it could not be passed spontaneously through the pylorus, so we tried to remove the bur by esophagogastroduodenoscopy. Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure.

상부위장관 이물질의 섭취는 대부분 위장관에서 자연적으로 배출되지만, 20% 정도에서는 내시경 또는 수술적 제거의 적응증이 된다. 특히 치과치료중 소아가 삼킬 수 있는 여러 가지 기구 중 bur 등은 예리하고 길이가 길기 때문에 생리적 협착 부위에서 걸려 자연배출이 힘들 수 있다. 또한시간이 지날수록 식도벽에 고착되고 궤양 등의 합병증을 일으켜 내시경으로 제거하기가 어렵기 때문에 소아가 삼켰을 경우 신속한 대처가 필요하겠다.

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