Arq bras odontol 2010; 6(1):19-24 ISSN 1808-2998 SWALLOWED PARTIAL DENTURE: A CASE REPORT AND A LITERATURE REVIEW Deglutição acidental de prótese parcial removível: relato de um caso e revisão da literatura Bruno Ramos Chrcanovic 1 , Antônio Luís Neto Custódio 2 1 Dentist graduated by Pontifical Catholic University of Minas Gerais; 2 Professor Adjunct (PhD) of the Department of Dentistry – Pontifical Catholic University of Minas Gerais Work conducted at Oral and Maxillofacial Surgery Clinic, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil __________________________________________________________________________________________ ABSTRACT - Foreign body ingestion is a common occurrence and the majority of foreign bodies that reach the gastrointestinal tract pass spontaneously. However, some patients require non-operative intervention or even surgery. Unexplained abdominal pain should alert the clinician to the possibility of foreign body ingestion. The one-tooth removable partial denture provides no cross-arch stabilization and there is the chance that it may be swallowed if it becomes dislodged. Patients should be educated on the importance of adherence to instructions of mechanics of use, life span, maintenance of dentures, and maintenance recall visits to assess the retention of dentures. It is also important the incorporation of radiopaque material in dental appliances, because the location of a swallowed or aspirated dental prosthesis often is accomplished radiographically. The aim of this paper is to report a case of a patient who swallowed a unilateral partial denture, which was removed by laparotomy. DESCRIPTORS - Partial denture, foreign body, swallowing, laparotomy ___________________________________________________________________________ INTRODUCTION Foreign body ingestion is a common occurrence and the majority of foreign bodies that reach the gastrointestinal tract pass spontaneously. However, 10 to 20% of the patients require non-operative intervention, and 1% or less require surgery. 1 The majority of foreign body ingestion occurs in the pediatric population. In adults, it occurs more commonly among those with psychiatric disorders, mental retardation, alcoholism, those seeking some secondary gain with access to a medical facility, and denture wearers. 2,3 It were reported a case of suicide attempted by ingestion of dentures, ingestion in mentally incompetent patient, and a dislodged fixed partial denture while undergoing general anesthesia. 4,5 Swallowing seems to be more common than aspiration, and is observed most often in the elderly. 6 Cases of swallowed dental prostheses are occasionally reported in the medical and dental literature. The diagnosis of an inadvertently swallowed foreign body is usually delayed. The ingestion may not result in any signs or symptoms and the denture may be found totally by chance. It becomes apparent when complications arise, such as throat pain or discomfort, persistent sensation of foreign body in the throat, retrosternal pain, tenderness in the neck, total dysphagia, pooling of saliva in the oropharynx, perforation, abscess or enterocolic fistula formation. 2 The patient could also have sweating and a raised temperature and coughing up blood. 2 Foreign body ingestion should be considered as a differential diagnosis in patients who present with abdominal and constitutional symptoms, and whose laboratory examination results for more common pathologies are negative. 7 Reported late complications of the undiagnosed swallowed denture include extraluminal migration from the esophagus causing either a diverticulum or perforation (once a perforation has occurred, further severe sequelæ may be anticipated, e.g. tracheo-oesophageal fistula), enterocolonic fistula, sigmoid colon perforation and death. 8-10 It was reported a case in which a removable partial denture was seen seated in the mid portion of the esophagus with its lateral wings deeply embedded in the wall of the esophagus causing laceration and severe hemorrhage. 11