Aspiration and Bronchoscopic Retrieval of Dental Objects: A Literature Review and Data Analysis of Reported Cases

Foreign body aspiration of dental objects is an uncommon but potentially serious complication of dental procedures. This study comprehensively reviewed published cases of dental object aspiration in adults, summarized clinical presentations and complications, and evaluated the success of bronchoscopic retrieval approaches and tools used.

A search of PubMed from 1984 through 2023 was performed using the terms "dental" and "aspiration" and "bronchoscopy." Case reports and case series of adult patients requiring health care intervention were included.

A total of 100 patients from 74 publications were included. Mean age was 63.5 years and 18% were female. The most common comorbidities were cognitive impairment (6%), hypertension (6%), and coronary artery disease (5%). The most frequently aspirated objects were dental prostheses (29%), crowns (22%), and implant drivers (17%). Blunt shapes predominated (61%). Objects were most commonly lodged in the right lower lobe (26%) and right mainstem bronchus (21%). Chest X-ray was the initial imaging modality for 92%. Flexible bronchoscopy was the preferred initial retrieval approach (59%), with bronchial forceps the most commonly used tool (34%). Initial retrieval was successful for 75%. Backup approaches were successful for 94.7%.

In conclusion, the elderly and/or cognitively impaired patients are most at risk for dental object aspiration. Chest X-ray was favored for treatment planning. Flexible bronchoscopy with the use of a bronchial forceps was the most successful combination for management of dental object aspiration. Clinicians may find these approaches useful when treating dental object aspiration.