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 Table of Contents  
CASE REPORT
Year : 2010  |  Volume : 1  |  Issue : 4  |  Page : 246-248  

Unusual objects in the root canal of deciduous teeth: A report of two cases


Department of Pedodontics & Preventive Dentistry, K. D. Dental College and Hospital, Mathura, Uttar Pradesh, India

Date of Web Publication1-Feb-2011

Correspondence Address:
Sudhindra Baliga
Department of Pedodontics & Preventive Dentistry, K. D. Dental College and Hospital, Delhi-Agra National Highway# 2, P. O. Chattikara, Mathura, 281001, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-237X.76393

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   Abstract 

Accidental foreign body ingestion or aspiration is a common problem in children. Children often have a habit of inserting objects into their mouth. Some of these objects can be accidentally ingested or even aspirated which can be frightening and a stressful experience. But the presence of foreign objects in the teeth are rare. The foreign objects in the teeth may act as a potential source of infection and pain. In most of the cases, children avoid informing their parents due to fear of punishment. This paper presents two cases of foreign objects embedded in the deciduous teeth. In both the cases, parents were not aware of foreign body ingestion by their children.

Keywords: Root canal, deciduous teeth, foreign body, unusal objects


How to cite this article:
Holla G, Baliga S, Yeluri R, Munshi AK. Unusual objects in the root canal of deciduous teeth: A report of two cases. Contemp Clin Dent 2010;1:246-8

How to cite this URL:
Holla G, Baliga S, Yeluri R, Munshi AK. Unusual objects in the root canal of deciduous teeth: A report of two cases. Contemp Clin Dent [serial online] 2010 [cited 2019 Aug 22];1:246-8. Available from: http://www.contempclindent.org/text.asp?2010/1/4/246/76393


   Introduction Top


The occurrence of foreign bodies such as metal screws, [1] staple pins, [2],[3] darning needles, [4] pencil leads, [5] beads [6] and tooth picks lodged in the exposed pulp chambers of carious or traumatically injured deciduous and permanent teeth has been reported. Most often, these cases are diagnosed accidentally on radiographic examination of the tooth which may be associated with infection, pain, swelling and recurrent abscesses as a sequelae to the pulpal exposure and lodgement of the foreign body.

Clinical and radiographic examinations are necessary to confirm the presence, size, location and the type of the foreign object. Two cases of foreign objects found within the pulp chambers of the deciduous teeth with their management are presented here.


   Case Reports Top


Case 1

A 10-year-old girl reported with a chief complaint of pain and pus discharge from the upper front tooth on the right side. Patient gave a history of pain since 10 days and pus discharge from the tooth since last 2 days.

On clinical examination, there was discoloration and open pulp chamber in relation to right maxillary deciduous canine (53) [Figure 1]. Radiographic examination of the tooth revealed a radio-opaque object resembling twisted pieces of metal wire lodged within the pulp chamber and root canal of 53 [Figure 2]. The tooth was extracted under local anesthesia [Figure 3]. On removal of the foreign objects in relation to the tooth, it was found that there were two staple pins and a small piece of aluminium foil [Figure 4]. The child, who had previously denied placing inserting within the tooth, later confessed that she had placed the objects to remove food particles and to get relief from pain.
Figure 1 :Photograph of discolored deciduous maxillary canine on the right side

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Figure 2 :Radiograph showing the foreign object in the tooth

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Figure 3 :Photograph showing the metallic object in the extracted tooth

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Figure 4 :Two staple pins and pieces of aluminum foil recovered from the tooth

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Case 2

A 5-year-old male child was brought to the department by their parents with a complaint of pain in relation to decay in the upper front teeth. Clinical examination revealed that the deciduous right maxillary central incisor (51) was grossly decayed with open pulp chamber [Figure 5]. Intraoral periapical radiographs of the maxillary anterior region examination revealed the presence of a radio-opaque foreign object within the pulp chamber and root canal of 51[Figure 6].
Figure 5 :Photograph showing decayed maxillary incisors

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Figure 6 :Radiograph showing the foreign object in the tooth resembling the head of sewing needle

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The tooth was extracted under local anesthesia and the object was retrieved from the canal, which was found to be the broken head of a sewing needle [Figure 7].
Figure 7 :Head of sewing needle recovered from the tooth

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   Discussion Top


As children often tend to have the habit of inserting foreign objects in the oral cavity, there are more chances of finding foreign objects in their teeth. Sometimes, children do not reveal to their parents due to fear. In such cases, the presence of foreign body is detected on routine radiographs. These foreign objects may act as a potent source of infection and painful condition. Grossman, [7] Gelfman, [8] and Harris [9] reported retrieval of indelible ink pencil tips, brads, a tooth pick, adsorbent points, tomato seed, pins, wooden toothpick, a pencil tip, plastic objects, toothbrush bristles and crayons from the root canals of anterior teeth left open for drainage.

McAuliffe [2] has suggested various radiographic methods to be followed to localize a radio-opaque foreign object, such as Parallax views, Vertex occlusal views, Triangulation techniques, Stereo Radiography and Tomography. The Steglitz forceps have also been described for use of removal of silver points from the root canal. There is a description of an assembly of a disposable injection needle and thin steel wire loop, formed by passing the wire through the needle being used. This assembly was used along with a mosquito hemostat to tighten the loop around the object. [10]

In the cases reported here, the foreign objects were in the primary teeth. In the first case, the patient first denied of inserting anything in the tooth but on further questioning she admitted of inserting staple pins, foils and papers in the tooth. As the prognosis was poor, the tooth was extracted. On removal of the foreign objects from the extracted tooth, we found two staple pins and a piece of aluminum foil.

In the second case, the child came with a complaint of pain in the primary central incisor. On routine radiographic examination, broken head of sewing needle was found. Again here, the parents were not aware of the fact that child had inserted sewing needle in the tooth. But the parents were not willing to come again and were insisting for the removal of the tooth. Thus, this tooth was also extracted under local anesthesia.

Though the presence of foreign objects retrieved from the root canals and pulp chambers of the permanent teeth have been reported, the presence of foreign objects found in the deciduous teeth is an uncommon situation. Timely diagnosis and management of foreign object embedded in the tooth should be done to avoid further complication.

 
   References Top

1.Prabhakar AR, Basappa N, Raju OS. Foreign body in a mandibular permanent molar: A case report. J Ind Soc Pedod Prev Dent 1998;16:120-1.   Back to cited text no. 1
    
2.Aduri R, Reddy RE, Kiran K. Foreign objects in teeth: Retrieval and management. J Ind Soc Pedod Prev 2009;27:179-83.  Back to cited text no. 2
    
3.Macauliffe N, Drage NA, Hunter B. Staple diet: A foreign body in a tooth. Int J Paediatr Dent 2005;15:468-71.   Back to cited text no. 3
    
4.Nernst H. Foreign body in the root canal. Quintessence 1972;23:26.   Back to cited text no. 4
    
5.Hall JB. Endodontics - Patient performed. J Dent Child 1969;36:213-6.   Back to cited text no. 5
    
6.SubbaReddy VV, Mehta DS. Beads. Oral Surg Oral Med Oral Pathol 1990;69:769-70.   Back to cited text no. 6
[PUBMED]    
7.Grossman JL, Heaton JF. Endodontic case reports. Dent Clin North Am 1974;118:509-27.   Back to cited text no. 7
    
8.Zillich RM, Pickens TN. Patient-included blockage of the root canal: Report of a case. Oral Surg Oral Med Oral Pathol 1982;54:689-90.   Back to cited text no. 8
[PUBMED]    
9.Harris WE. Foreign bodies in root canals: Report of two cases. J Am Dent Assoc 1972;85:906-11.   Back to cited text no. 9
[PUBMED]    
10.Roig-Greene JL. The retrieval of foreign objects from root canals: A simple aid. J Endod 1983;9:394-7.  Back to cited text no. 10
[PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]



 

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