Abstract
Traumatic dental injuries are more commonly seen in children and it often results
in a complicated crown fracture. This case is unique as foreign objects in the form
of hand-sewing needles were accidentally lodged bilaterally in both maxillary central
incisors. A 13-year-old patient was referred to the Dental Clinics at the College
of Dentistry, Jazan University with a complaint of broken needles in her front teeth
and a history of trauma 3 years ago. Although the patient had the habit of using a
hand-sewing needle to remove the lodged food particles from the open pulp chamber,
she was not able to recollect the incidence of needle separations. Radiographic examination
revealed radiopaque objects in the middle third of the right maxillary central incisor
(#11) and in the apical third of the left maxillary central incisor (#21). Tooth #11
was clinically diagnosed as pulp necrosis with chronic apical abscess and tooth #21
as pulp necrosis with asymptomatic apical periodontitis. The micro tweezer from the
broken instrument removal kit (Zumax Medical Co.,Ltd., Jiangsu, China) was used to
retrieve the separated needle pieces under the operating microscope. The open apices
were managed by the formation of mineral trioxide aggregate apical plug, and the procedure
of root reinforcement was achieved by bonded resin cement and fiber resin posts. Finally,
teeth were restored with dual cure core build-up composite material and direct composite
veneers. Recommendations are made to treat complicated crown fractures, especially
in children on priority to minimize the risk of foreign object impaction.
Keywords
foreign object - hand-sewing - maxillary central incisors - needle - root canal
