Dental Journal of Iwate Medical University

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A report is submitted concerning two cases of accidental swallowing during dental treatment. Case 1 : A 72-year-old male swallowed the full cast crown of the lower left second molar during a trial fitting. An abdominal X-ray film revealed that it was lodged in the stomach. From the findings of another abdominal X-ray film taken six days after the accident, the foreign body had disappeared without any complications, indicating its natural excretion. Case 2 : A 44-year-old male swallowed the inlay of the upper left second premolar during fitting. Observation of an abdominal X-ray film showed the existence of the inlay in the stomach. Three days after the swallowing, it was confirmed by the patient that it was discharged from his body with his feces with no complications. It should be noted that both taking a chest and/or abdominal X-ray film and having an examination by a medical specialist, if possible, is considered better procedure in the case of accidental swallowing and aspiration during dental treatment.

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Immediate implant placement following extraction is suggested as a method of implant treatment. As this method is associated with almost no gingival recession or absorption of alveolar bone in the extraction socket, and as the period of treatment can be shortened, its usefulness has been widely reported. In this case, implant placement was performed immediately after extraction of an upper left first premolar in which a root fracture had been discovered, with porcelain fused to a metal crown used as the superstructure. Through implant placement immediately following extraction, postoperative gingival recession and bone absorption were kept to a minimum, and esthetic recovery was achieved. Moreover, the period of treatment up to functional recovery was shortened, showing that this can be an effective method of treatment in prosthetic dentistry when applied to suitable cases.

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We observed four fused teeth of the mandibular lateral incisor and the mandibular canine on three patients. In Case 1, both sides of the teeth were fused to the tooth crown and root. From observation of dental radiography, we were able to confirm that the fusion area of these teeth reached to the dentin. In Case 2, the tooth crown was divided into two parts, mesial and distal, and was fused to the tooth root. From observation of dental radiography, the fusion area of the tooth was confirmed to reach to the dentin. In Case 3, we were able to confirm from observation of plaster model that the tooth crown was fused completely. The appearance rate of fused permanent teeth was 0.3%. We thought that the abnormal cases appeared as a result of many embryological phenomena. We propose that the abnormal cases should be reported along with the detail data, and not thought to be rare.

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