ENDOSCOPIC MANAGEMENT OF THE INGESTION OF DENTAL PROSTHESES

Aims:

Dental prostheses constitute a significant proportion of ingested foreign bodies. Ingestion is most often accidental during sleep or during trauma or convulsion. Their presence in the digestive tract can be completely asymptomatic or cause dysphagia and pain.

Methods:

This is a retrospective study including patients admitted for ingestion of dental prostheses in our unity. An upper endoscopy was performed in all patients.

Results:

Of the 53 cases of ingestion of foreign bodies, dental prostheses accounted for 20.8% of cases (n = 11). The mean age was 38.6 years [17 – 60] with a sex-ratio H/F of 2.6 (8 men, 3 women). Ingestion was accidental in all patients. These were bridges in 8 cases (72.7%), or dental equipment with wire or hook in 3 cases (27.2%). The diagnostic delay was less than a week after ingestion in 9 patients, 3 months in one patient and 7 months in another. 8 patients had consulted for dysphagia and one patient for chest pain. In endoscopic exploration, the dental prosthesis was found in the esophagus: just below the mouth of the esophagus in 2 cases, in the cervical esophagus in one case, in the thoracic esophagus in 4 cases and at the level of the pylorus in 1 patient. The abdominal X-ray has also highlighted a prosthesis at the level of the right iliac fossa. Endoscopic extraction was successful in 4 patients. The attempted extraction failed in 4 patients because the prostheses were found adhered to the esophageal wall. They were therefore referred to surgery. In the remaining 3 patients, removal of the prosthesis was spontaneous.

Conclusions:

Endoscopic management of dental appliances is not always obvious, especially when the diagnosis is delayed and the dental prosthesis is already anchored in the esophageal wall which can cause significant inflammatory reactions and ulcerations leading to surgical extraction.