Unusual foreign body in primary tooth.

Abstract

To cite: Kanumuri PK, Gantha SN, Animireddy D, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016216326 DESCRIPTION Foreign bodies inside teeth are diagnosed accidentally on clinical or radiographic examination of teeth. These may be associated with infection, pain, swelling, and recurrent abscesses as a sequel to the pulpal exposure and lodgement of the foreign body. Various foreign bodies reported were pencil leads, metal screws, stapler pins and tooth-picks. The exogenous material acts as a focus for infection and may cause tissue irritation. There are various radiographic methods, such as Parallax views, Triangulation techniques, Stereo Radiography, Tomography, Radiovisiography and CT scans, that can play a pivotal role in focusing on the localisation of foreign objects inside the root canal. The dentist plays a vital role in diagnosis of such embedded foreign bodies. The case presented here is of a similar entity, but with an unusual embedded foreign body. A 10-year-old male patient presented to the department with pain in the lower left back tooth region for the past 1 week. Pain was intermittent, moderate, throbbing in nature and non-radiating, with no history of abscess. Clinical examination revealed a grossly decayed primary mandibular left second molar (75 ISO system) (figure 1). Intraoral periapical radiograph had been taken in relation to that region, and many multiple radiopaque lines were observed extending from pulp chamber on to its successor (35 ISO system) in the furcation area (figure 2). It was assumed to be an artefact, as there was no visible foreign body. The radiograph was then repeated to confirm the diagnosis and similar findings were observed. Extraction of 75 was carried under local anaesthesia, along with administration of a tetanus vaccine booster. Seven metal wires and one staple pin were retrieved along with the extracted tooth (figure 3). When questioned about the existence of the foreign body, the patient admitted placing several metal wires from a sand sieving mesh and also a stapler pin into the tooth to relieve pain. Systemic antibiotics and analgesics

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