Abstract
Accidental ingestion of instruments during dental treatment is one type of accidental injury. If the tip of the fracture fragment is sharp, there is a risk of gastrointestinal rupture, so immediate action is required when it occurs. In the present report, we describe a case in which a fracture fragment of a carbide bar was accidentally swallowed during extraction of a mandibular wisdom tooth, and was removed under upper gastrointestinal endoscopy. A 42-year-old male was referred by a local dentist to our department in August 2021 for extraction of a left-sided mandibular wisdom tooth. The crown of the left mandibular wisdom tooth had partially erupted and there was no evidence of inflammation of the surrounding gingiva. Panoramic radiography revealed that the left mandibular wisdom tooth was centrally inclined and semi-embedded. Extraction was performed under local anesthesia. The mucoperiosteal valve was formed and the crown and root division of the left mandibular wisdom tooth was being performed when the carbide bar fractured. A panoramic radiograph taken immediately afterwards revealed an opaque image in the pharyngeal region that could have been fracture fragments, but computed tomography （CT） showed no fracture fragments in the head and neck region. An abdominal X-ray showed an opaque image in the gastric region, which was thought to be a fracture fragment. On the same day, the patient underwent endoscopic removal of the foreign body from the upper gastrointestinal tract at the Department of Gastroenterology of this hospital.
